Therapy-associated polyposis as a late sequela of cancer treatment

Clin Gastroenterol Hepatol. 2014 Jun;12(6):1046-50. doi: 10.1016/j.cgh.2013.11.040. Epub 2013 Dec 19.

Abstract

Survivors of childhood cancers are at increased risk of developing secondary gastrointestinal cancers, including colorectal cancer, later in life, possibly from exposure to abdominopelvic radiotherapy and/or alkylating chemotherapy. Profuse gastrointestinal polyposis is associated with rare, inherited colorectal cancer predisposition syndromes, most commonly caused by mutations in the adenomatous polyposis coli (APC) or mutY homolog (MUTYH) genes. We describe 5 patients who developed gastrointestinal polyposis many years after radiotherapy and chemotherapy for a childhood cancer. Genetic analysis of all 5 subjects did not identify pathogenic germline mutations in APC or MUTYH. Chemotherapy and/or radiotherapy therefore might cause gastrointestinal polyposis in some patients by undiscovered mechanisms.

Keywords: Adenomas; Chemotherapy; Polyps; Radiation.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adenomatous Polyposis Coli Protein / genetics
  • Adolescent
  • Adult
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • DNA Glycosylases / genetics
  • Female
  • Genotype
  • Humans
  • Infant
  • Intestinal Polyposis / chemically induced*
  • Male
  • Middle Aged
  • Neoplasms / therapy*
  • Radiotherapy / adverse effects*
  • Young Adult

Substances

  • APC protein, human
  • Adenomatous Polyposis Coli Protein
  • Antineoplastic Agents
  • DNA Glycosylases
  • mutY adenine glycosylase