Pancreaticoduodenectomy for locally advanced colon cancer in hereditary nonpolyposis colorectal cancer

BACKGROUND: Hereditary nonpolyposis colorectal cancer (HNPCC), or Lynch syndrome, accounts for 3 % of newly diagnosed cases of colorectal cancer. While a partial or subtotal colectomy is indicated for early stage disease, there is a paucity of data addressing locally advanced disease involving the foregut. CASE PRESENTATION: We report two patients with hereditary nonpolyposis colorectal cancer presenting with locally advanced colon cancer surgically managed by pancreaticoduodenectomy with en bloc partial colectomy and a review of the literature. CONCLUSIONS: Locally advanced colorectal cancer in HNPCC is a rare clinical entity that requires special surgical consideration. Multidisciplinary treatment, including multi-visceral resection, offers the best long-term outcome.