A Case of Multiple Colon Cancers with Paroxysmal Nocturnal Hemoglobinuria

• Published in: The Japanese Journal of Gastroenterological Surgery Vol. 44; no. 4; pp. 497 - 503
• Main Authors: Ohno, Masahiro, Tominaga, Masahiro, Fujino, Yasuhiro, Fujita, Toshitada, Tanaka, Kenichi, Mikami, Jota
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Gastroenterological Surgery 2011
• Subjects: colon cancer; paroxysmal nocturnal hemoglobinuria (PNH)
• ISSN: 0386-9768; 1348-9372
• DOI: 10.5833/jjgs.44.497

We report a rare case of colon cancer with paroxysmal nocturnal hemoglobinuria (PNH). A 56-year-old woman hospitalized for anaplastic anemia at age 40 was administered steroids, thereafter reporting defecation difficulties. Examinations showed type 2 advanced ascending colon and rectal cancer. Bone marrow biopsy showed no anaplastic anemia, but weak dysplasia and hyperplasia considered due to hemolytic anemia. These results and symptoms yielded a diagnosis of multiple colon cancers with moderate PNH, necessitating right hemicolectomy and low anterior resection in December 2006. Foot pumps, but no anticoagulant agents, were used to prevent blood clots. She was administered steroid cover from the beginning of surgery. She was transfused with washed red blood cells to compensate for blood loss. To prevent bone marrow suppression, we did not use a nitrous oxide anesthetic. Operating time was 6.5 hours and blood loss 460ml. No marked adverse effects, such as hemolytic attack or thrombosis, were seen postoperatively.