Abstract
A 19-year-old male was diagnosed as multiple cancer in the colon and rectum combined with gastric cancer. A distal gastrectomy and a subtotal colectomy were carried out. Reconstructions were performed with the gastroduodenostomy and the colo-rectal anastomosis. Histological examination of the tumor in the stomach revealed signet ring cell carcinoma infiltrating into the subserosal layer. Histological examinations of the subserosal layer. Histological examinations of the resected specimens of the colon and rectum revealed a submucosal-infiltrated (sm) Ia type cancer (moderately differentiated adenocarcinoma; mda), a subserosalinfiltrated invasive ulcerative type cancer (mda), and an sm localized IIc type cancer (mucinous carcinoma; mc) in the rectum, and an sm and a mucosal-infiltrated (m) Ia type cancer (well differentiated adenocarcinomas), an sm localized IIc type cancer (mda), two proper-muscular-infiltrated tumorous type cancers (mc) and four polypoid adenomas in the sigmoid and descending colon, and a cancer in adenoma in the transverse colon. He lives in safe without signs of recurrence 25 months after surgery. One hundred forty-five cases of colon and rectal cancer in persons less than 20 years old have been reported in Japan. There were six patients with multiple colon and rectal cancer in addition to this patient. Among these, one had familial polyposis, two had Turcot syndrome, one had non-familial polyposis, one had multiple cancer in the sigmoid colon and one had multiple cancer in the transverse colon. Except for the patients with Turcot syndrome, this is the first case of colon and rectal cancer combined with the cancer of another organ.
