[A Case of Stage ⅣRectal Cancer with Dyskeratosis Congenita].

Abstract

A 27-year-old man was diagnosed with dyskeratosis congenita from DKC1 gene mutation at 9 years of age and had been followed-up regularly.An upper gastrointestinal endoscopy performed for vomiting revealed gastric varices.Further examination resulted in a diagnosis of Stage Ⅳrectal cancer with portal hypertension, splenomegaly, liver, and lung metastasis and he was referred to our department.A laparoscopic splenectomy was performed, followed by a laparoscopic low anterior resection for rectal cancer.Subsequently, resection of the pulmonary and liver metastasis was performed, resulting in macroscopic radical resection.However, 3 months after the hepatectomy, unresectable multiple lung metastasis was detected and he received 5 courses of chemotherapy with cetuximab.A grade 3 skin rash was observed and chemotherapy was discontinued. After 5 courses, he had pneumothorax and received drainage.He had sudden respiratory failure 2 days after pleural adhesion therapy of OK-432 was performed.He was diagnosed with interstitial pneumonia induced by OK-432 and steroid pulse therapy, which resulted in his death without improvement 21 days after admission.

• Authors: Keishi Nakamura, Shiro Terai, Yoshinao Ohbatake, Koichi Okamoto, Shinichi Nakanuma, Seisho Sakai, Jun Kinoshita, Isamu Makino, Tomoharu Miyashita, Hidehiro Tajima, Hiroyuki Takamura, Itasu Ninomiya, Sachio Fushida, Tetsuo Ohta
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 46 Issue 3 Pg. 515-517 (Mar 2019) ISSN: 0385-0684 [Print] Japan
• PMID: 30914599 (Publication Type: Case Reports, Journal Article)

Chemical References

• Cetuximab

Topics

• Adult
• Antineoplastic Combined Chemotherapy Protocols
• Cetuximab
• Child
• Dyskeratosis Congenita (complications)
• Humans
• Liver Neoplasms (secondary)
• Male
• Rectal Neoplasms (complications, pathology)