Sekundarni maligni tumor debelega črevesja po zdravljenju raka v otroštvu

Lorna Zadravec-Zaletel (Author), Miroslav Vujasinović (Author), Marko Boc (Author), Berta Jereb (Author)

Abstract

Tveganje za nastanek sekundarnega raka debelega črevesja je pri bolnikih, ki so se zdravili zaradi raka v otroštvu, večje od tistega v splošni populaciji in strmo narašča s časom opazovanja ter s povečano dozo obsevanja v predelu trebuha. Pri bolniku, ki je bil v starosti 12 let uspešno zdravljen zaradi Hodgkinove bolezni s kemoterapijo in obsevanjem prizadetih regij, vključno paraaortnih bezgavk, je bila 27 let po zdravljenju ugotovljena mikrocitna hipohromna anemija. Sum, da gre za gastrointestinalno krvavitev z enkratno preiskavo blata, ni bil potrjen. Pol leta kasneje je bil ugotovljen metastatski adenokarcinom debelega črevesja. Zdravljen je bil operativno, s sistemskim zdravljenjem in paliativnim obsevanjem spinalnih ter možganskih metastaz. Leto in pol po začetku zdravljenja sekundarnega tumorja je bolnik v starosti 40 let umrl. Pri bolnikih, zdravljenih zaradi raka v otroštvu, so pozne posledice številne. Sekundarni maligni tumorji so drugi najpogostejši vzrok smrti, takoj za recidivom bolezni. Zato je zelo pomembno, da jih pravočasno odkrijemo in ustrezno zdravimo. Od leta 2014 je za bolnike, ki so prejeli 30 Gy ali več na predel trebuha, v mednarodnih smernicah priporočeno spremljanje s kolonoskopijo. Enkratna preiskava blata na kri in UZ trebuha nista zanesljivi metodi za odkrivanje raka debelega črevesja.

Keywords

kasne posledice raka;rak pri otrocih;rak;otroci;

Data

Language:	Slovenian
Year of publishing:	2014
Typology:	1.09 - Published Professional Conference Contribution
Organization:	OI - Institute of Oncology
UDC:	616-006
COBISS:	1810555
ISSN:	1408-1741
Parent publication:	Šola: tumorji prebavil II, Ljubljana, 15. 11. 2013
Views:	2400
Downloads:	619
Average score:	0 (0 votes)
Metadata:

Other data

Secondary language:	English
Secondary title:	[Secondary malignant tumour of the colon after childhood cancer treatment - a case report]
Secondary abstract:	The risk of developing secondary colon cancer is larger in patients treated for childhood cancer than in the general population, and it is rapidly increasing with observation time and increased radiation dose to the abdominal area. A patient, who was successfully treated for Hodgkin’s disease at the age of 12 with chemotherapy and radiation of the affected regions, including para-aortic lymph nodes, was diagnosed with microcytic hypochromic anaemia 27 years after treatment. A suspicion that this is gastrointestinal haemorrhage was not confirmed by a single-stool examination. Half a year later, the patient was found with metastatic adenocarcinoma of the colon and was treated operatively with systemic treatment and palliative radiation of spinal and brain metastases. A year and a half after the start of treatment of secondary tumour, the patient died at the age of 40 years. Patients treated for childhood cancer experience several late consequences. Secondary malignant tumours are the second most common cause of death, right after disease recurrence. Therefore, timely detection and appropriate treatment are of utmost importance. Since 2014, the international guidelines recommend that patients receiving 30 Gy or more to the abdominal region are monitored by colonoscopy. A single-stool examination for occult blood and US of the abdomen are not reliable methods for detecting colon cancer.
URN:	URN:NBN:SI
Pages:	str. 69-71, 77
Volume:	ǂLetn. ǂ18
Issue:	ǂšt. ǂ1
Chronology:	jun. 2014
ID:	10956224