Cancer of the ampulla of vater in lynch syndrome : a case report.

A 56-years-old male presented at our hospital due to the symptoms of anemia, liver disfunction and colon polyps. He had resected rectal cancer at the ages of 41 and has no family history of colorectal cancer. A thorough examination for anemia resulted in detection of multiple colon cancer and cancer on ampulla of Vater. We performed total colectomy with dissection of regional lymph nodes and pancreaticoduodenectomy with dissection of regional lymph nodes. Immunohistochemical analysis showed a lack of MSH2 and MSH6 protein in the colon cancer and cancer on ampulla of Vater, and germline mutation of hMSH2 gene was recognized. Therefore, we diagnosed the case as Lynch syndrome. [ABSTRACT FROM AUTHOR]