Colorectal carcinoma masked by systemic inflammatory response syndrome: A case report

Wei,Hongyun; Choudhary,Waqas; He,Rong; Ouyang,Chunhui; Cheng,Zongyong; Liu,Deliang; Lu,Fanggen; Liu,Xiaowei

doi:10.3892/ol.2017.6820

Colorectal carcinoma masked by systemic inflammatory response syndrome: A case report

Authors:
- Hongyun Wei
- Waqas Choudhary
- Rong He
- Chunhui Ouyang
- Zongyong Cheng
- Deliang Liu
- Fanggen Lu
- Xiaowei Liu
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Affiliations: Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China, Department of Gastroenterology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
Published online on: August 24, 2017 https://doi.org/10.3892/ol.2017.6820
Pages: 4906-4910

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Abstract

The present study described the case of a 68‑year‑old woman who presented to the Second Xiangya Hospital of Central South University (Changsha, China) with progressive abdominal pain, distention and diarrhea. These symptoms were diagnosed as the initial manifestations of systemic inflammatory response syndrome associated with colorectal carcinoma (CRC). The presentation appeared as a common emergency medical case, which was eventually recognized as a CRC masked by this emergency symptom. This case highlights the fact that a correct diagnosis can be made by looking through the outward appearance to perceive the essence of the condition. Therefore, vigilant surveillance is of utmost importance in order to expedite prompt recognition and rapid management of this presentation of CRC.

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1	Siegel RL, Miller KD and Jemal A: Cancer Statistics, 2017. CA Cancer J Clin. 67:7–30. 2017. View Article : Google Scholar : PubMed/NCBI
2	Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D and Bray F: Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 136:E359–E386. 2015. View Article : Google Scholar : PubMed/NCBI
3	Siegel RL, Miller KD, Fedewa SA, Ahnen DJ, Meester RGS, Barzi A and Jemal A: Colorectal cancer statistics, 2017. CA Cancer J Clin. 67:177–193. 2017. View Article : Google Scholar : PubMed/NCBI
4	Müller F, Tuinman MA, Janse M, Almansa J, Sprangers MAG, Smink A, Ranchor AV, Fleer J and Hagedoorn M: Clinically distinct trajectories of fatigue and their longitudinal relationship with the disturbance of personal goals following a cancer diagnosis. Br J Health Psychol. Jun 21–2017.(Epub ahead of print). View Article : Google Scholar
5	Baer C, Menon R, Bastawrous S and Bastawrous A: Emergency presentations of colorectal cancer. Surg Clin North Am. 97:529–545. 2017. View Article : Google Scholar : PubMed/NCBI
6	McArdle CS and Hole DJ: Emergency presentation of colorectal cancer is associated with poor 5-year survival. Br J Surg. 91:605–609. 2004. View Article : Google Scholar : PubMed/NCBI
7	McMillan DC, Canna K and McArdle CS: Systemic inflammatory response predicts survival following curative resection of colorectal cancer. Br J Surg. 90:215–219. 2003. View Article : Google Scholar : PubMed/NCBI
8	Hoque R, Farooq A and Mehal WZ: Sterile inflammation in the liver and pancreas. J Gastroenterol Hepatol. 28 Suppl 1:S61–S67. 2013. View Article : Google Scholar
9	Beal AL and Cerra FB: Multiple organ failure syndrome in the 1990s. Systemic inflammatory response and organ dysfunction. JAMA. 271:226–233. 1994. View Article : Google Scholar : PubMed/NCBI
10	Scott HF, Deakyne SJ, Woods JM and Bajaj L: The prevalence and diagnostic utility of systemic inflammatory response syndrome vital signs in a pediatric emergency department. Acad Emerg Med. 22:381–389. 2015. View Article : Google Scholar : PubMed/NCBI
11	Carruthers R, Tho LM, Brown J, Kakumanu S, McCartney E and McDonald AC: Systemic inflammatory response is a predictor of outcome in patients undergoing preoperative chemoradiation for locally advanced rectal cancer. Colorectal Dis. 14:e701–e707. 2012. View Article : Google Scholar : PubMed/NCBI
12	McSorley ST, Black DH, Horgan PG and McMillan DC: The relationship between tumour stage, systemic inflammation, body composition and survival in patients with colorectal cancer. Clin Nutr. May 19–2017.(Epub ahead of print). View Article : Google Scholar : PubMed/NCBI
13	Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RM and Sibbald WJ: Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM consensus conference committee. American college of chest physicians/society of critical care medicine. Chest. 101:1644–1655. 1992. View Article : Google Scholar : PubMed/NCBI
14	Landis RC: 20 Years on: Is it time to redefine the systemic inflammatory response to cardiothoracic surgery? J Extra Corpor Technol. 47:5–9. 2015.PubMed/NCBI
15	Castillo-Lara RA, Soria-Ruiz M and Martínez-Carrera O: Definitions for sepsis and organ failure. JAMA. 270:9391993. View Article : Google Scholar : PubMed/NCBI
16	Kudo S, Tamura S, Nakajima T, Yamano H, Kusaka H and Watanabe H: Diagnosis of colorectal tumorous lesions by magnifying endoscopy. Gastrointest Endosc. 44:8–14. 1996. View Article : Google Scholar : PubMed/NCBI
17	Fujita T: Preoperative but not postoperative systemic inflammatory response correlates with survival in colorectal cancer (Br J Surg 2007; 94: 1028–1032). Br J Surg. 94:1439–1440. 2007. View Article : Google Scholar : PubMed/NCBI
18	Crozier JE, Leitch EF, McKee RF, Anderson JH, Horgan PG and McMillan DC: Relationship between emergency presentation, systemic inflammatory response, and cancer-specific survival in patients undergoing potentially curative surgery for colon cancer. Am J Surg. 197:544–549. 2009. View Article : Google Scholar : PubMed/NCBI
19	Vincent JL, Opal SM, Marshall JC and Tracey KJ: Sepsis definitions: Time for change. Lancet. 381:774–775. 2013. View Article : Google Scholar : PubMed/NCBI
20	Comstedt P, Storgaard M and Lassen AT: The systemic inflammatory response syndrome (SIRS) in acutely hospitalised medical patients: A cohort study. Scand J Trauma Resusc Emerg Med. 17:672009. View Article : Google Scholar : PubMed/NCBI
21	Cuevas-Ramos G, Petit CR, Marcq I, Boury M, Oswald E and Nougayrède JP: Escherichia coli induces DNA damage in vivo and triggers genomic instability in mammalian cells. Proc Natl Acad Sci USA. 107:11537–11542. 2010. View Article : Google Scholar : PubMed/NCBI
22	Becker S, Oelschlaeger TA, Wullaert A, Vlantis K, Pasparakis M, Wehkamp J, Stange EF and Gersemann M: Bacteria regulate intestinal epithelial cell differentiation factors both in vitro and in vivo. PLoS One. 8:e556202013. View Article : Google Scholar : PubMed/NCBI
23	Gupta A, Madani R and Mukhtar H: Streptococcus bovis endocarditis, a silent sign for colonic tumour. Colorectal Dis. 12:164–171. 2010. View Article : Google Scholar : PubMed/NCBI
24	Mazmanian SK, Liu CH, Tzianabos AO and Kasper DL: An immunomodulatory molecule of symbiotic bacteria directs maturation of the host immune system. Cell. 122:107–118. 2005. View Article : Google Scholar : PubMed/NCBI
25	Rakoff-Nahoum S, Paglino J, Eslami-Varzaneh F, Edberg S and Medzhitov R: Recognition of commensal microflora by toll-like receptors is required for intestinal homeostasis. Cell. 118:229–241. 2004. View Article : Google Scholar : PubMed/NCBI
26	Gagnière J, Raisch J, Veziant J, Barnich N, Bonnet R, Buc E, Bringer MA, Pezet D and Bonnet M: Gut microbiota imbalance and colorectal cancer. World J Gastroenterol. 22:501–518. 2016. View Article : Google Scholar : PubMed/NCBI
27	Cario E: Bacterial interactions with cells of the intestinal mucosa: Toll-like receptors and NOD2. Gut. 54:1182–1193. 2005. View Article : Google Scholar : PubMed/NCBI
28	Karin M and Greten FR: NF-kappaB: Linking inflammation and immunity to cancer development and progression. Nat Rev Immunol. 5:749–759. 2005. View Article : Google Scholar : PubMed/NCBI