Skip to main content

Advertisement

Log in

Successful treatment for Cronkhite-Canada syndrome with endoscopic mucosal resection and salazosulfapyridine

  • Case Report
  • Published:
Techniques in Coloproctology Aims and scope Submit manuscript

Abstract

A 79-year-old woman was referred to our hospital because numerous polyps were found in her stomach and large intestine at an ambulatory clinic. Although there were no characteristic symptoms or signs of Cronkhite-Canada syndrome (CCS), endoscopic and pathological findings indicated CCS. Moreover, colonoscopy showed two polypoid lesions (Is type), which appeared neoplastic by magnifying observation with image-enhanced endoscopy (IEE), in the ascending colon. Histologically, the resected specimens revealed tubular adenomas arising in the CCS inflammatory polyps. Remarkable remission of the polyps and edematous mucosa in the stomach and colon was seen after 8 months of administration of salazosulfapyridine (SASP) (3 g/day). Another adenoma was detected and removed endoscopically in the sigmoid colon. This is the first report to describe an asymptomatic case of CCS probably detected in the early phase of the disease, by magnifying IEE which enabled detection and treatment for associated colonic adenomas. SASP was effective in eradication of the inflammatory polyposis, and an additional adenoma was successfully found and removed by surveillance colonoscopy thereafter.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

References

  1. Cronkhite LW Jr, Canada WJ (1955) Generalized gastrointestinal polyposis. An unusual syndrome of polyposis, pigmentation, alopecia and onychotrophia. N Engl J Med 252:1011–1015

    Article  PubMed  Google Scholar 

  2. Daniel ES, Ludwig SL, Lewin KJ, Ruprecht RM, Rajacich GM, Schwabe AD (1982) The Cronkhite-Canada syndrome: an analysis of clinical and pathologic features and therapy in 55 patients. Medicine 47:504–510

    Google Scholar 

  3. Parsa C (1982) Cronkhite-Canada syndrome associated with systemic vasculitis: an autopsy study. Hum Pathol 13:758–760

    Article  CAS  PubMed  Google Scholar 

  4. Malhotra R, Sheffield A (1988) Cronkhite-Canada syndrome with colon carcinoma and adenomatous changes in C–C polyps. Am J Gastroenterol 183:772–776

    Google Scholar 

  5. Yashiro M, Kobayashi H, Kubo N, Nishiguchi Y, Wakasa K, Hirakawa K (2004) Cronkhite-Canada syndrome containing colon cancer and serrated adenoma lesions. Digestion 69:57–62

    Article  PubMed  Google Scholar 

  6. Saeki T, Yokoyama H, Fukuda T et al (1995) Cronkhite-Canada syndrome associated with sigmoid colon cancer. Jpn J Cancer Clin 41:1233–1239

    Google Scholar 

  7. Nagata J, Kijima H, Hasumi K, Suzuki T, Shirai T, Mine T (2003) Adenocarcinoma and multiple adenomas of the large intestine, associated with Cronkhite-Canada syndrome. Dig Liver Dis 35:434–438

    Article  CAS  PubMed  Google Scholar 

  8. Jain A, Nanda S, Chakraborty P et al (2003) Cronkhite-Canada syndrome with adenomatous and carcinomatous transformation of colonic polyp. Indian J Gastroenterol 22:189–190

    PubMed  Google Scholar 

  9. Yamashita T, Miyazawa M, Suzuki H (1996) A case of Cronkhite-Canada syndrome improved markedly with antiplasmin agent and steroid. Gastroenterol Endosc 38:45–50

    Google Scholar 

  10. Okamoto K, Isomoto H, Shikuwa S, Nishiyama H, Ito M, Kohno S (2008) A case of Cronkhite-Canada syndrome: remission after treatment with anti-Helicobacter pylori regimen. Digestion 78:82–87

    Article  PubMed  Google Scholar 

  11. Koishi T (1976) A case of Cronkhite-Canada syndrome. Nippon Naika Gakkai Zasshi J Jpn Soc Int Med 65:1060

    Google Scholar 

  12. Goto A, Shibuya C, Matsunami E (1984) Cronkhite-Canada syndrome. Shokaki Geka 15:111–143 (Seminar)

    Google Scholar 

  13. Kojima E, Tomita A, Matsumura M, Kinoshita M (2009) Magnifying the endoscopic appearance of Cronkhite-Canada syndrome. Gastrointest Endosc 70:1242–1243

    Article  PubMed  Google Scholar 

  14. Itzkowitz SH, Yio X (2004) Inflammation and cancer IV. Colorectal cancer in inflammatory bowel disease: the role of inflammation. Am J Physiol Gastrointest Liver Physiol 287:G7–G17

    Article  CAS  PubMed  Google Scholar 

  15. Pinczowski D, Ekbom A, Baron J, Yuen J, Adami HO (1994) Risk factors for colorectal cancer in patients with ulcerative colitis: a case-control study. Gastroenterology 107:117–120

    CAS  PubMed  Google Scholar 

  16. Rutter M, Saunders B, Wilkinson K et al (2004) Severity of inflammation is a risk factor for colorectal neoplasia in ulcerative colitis. Gastroenterology 126:451–459

    Article  PubMed  Google Scholar 

  17. Gupta RB, Harpaz N, Itzkowitz S et al (2007) Histologic inflammation is a risk factor for progression to colorectal neoplasia in ulcerative colitis: a cohort study. Gastroenterology 133:1099–1105

    Article  PubMed Central  PubMed  Google Scholar 

  18. Prantera C, Viscido A, Biancone L, Francavilla A, Giglio L, Campieri M (2005) A new oral delivery system for 5-ASA: preliminary clinical findings for MMx. Inflamm Bowel Dis 11:421–427

    Article  PubMed  Google Scholar 

  19. D’Haens G, Hommes D, Engels L et al (2006) Once daily MMX mesalazine for the treatment of mild-to-moderate ulcerative colitis: a phase II, dose-ranging study. Aliment Pharmacol Ther 24:1087–1097

    Article  PubMed  Google Scholar 

  20. Prantera C, Rizzi M (2009) 5-ASA in ulcerative colitis: improving treatment compliance. World J Gastroenterol 21:4353–4355

    Article  Google Scholar 

  21. Suzuki R, Irisawa A, Hikichi T et al (2009) Cronkhite-Canada syndrome associated with myelodysplastic syndrome. World J Gastroenterol 14:5871–5874

    Article  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to KI. Fu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ueyama, H., Fu, K., Ogura, K. et al. Successful treatment for Cronkhite-Canada syndrome with endoscopic mucosal resection and salazosulfapyridine. Tech Coloproctol 18, 503–507 (2014). https://doi.org/10.1007/s10151-012-0863-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10151-012-0863-0

Keywords

Navigation