Limits...
Metachronous, colitis-associated rectal cancer that developed after sporadic adenocarcinoma in an adenoma in a patient with longstanding Crohn's disease: a case report.

Takeyama H, Mizushima T, Nakajima K, Uemura M, Haraguchi N, Nishimura J, Hata T, Takemasa I, Yamamoto H, Doki Y, Mori M - World J Surg Oncol (2013)

Bottom Line: Colorectal cancer associated with Crohn's disease (CD) is increasing in proportion to the number of patients with CD in Japan.The patient received adjuvant chemotherapy with oral uracil 224 mg combined with tegafur 100 mg plus leucovorin.No signs of recurrence were noted at a follow-up 18 months after the third surgery and 60 months after the second surgery.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamada-Oka, Suita, Osaka 565-0871, Japan. tmizushima@gesurg.med.osaka-u.ac.jp.

ABSTRACT

Background: Colorectal cancer associated with Crohn's disease (CD) is increasing in proportion to the number of patients with CD in Japan. There are two subtypes of colorectal cancer with CD: sporadic cancer and colitis-associated cancer. Early diagnosis of colitis-associated cancer is sometimes difficult; when colorectal cancer is found in patients with CD, both colitis-associated cancer and sporadic cancer should be kept in mind. Here, we describe a case of metachronous, colitis-associated rectal cancer that developed after the complete resection of an adenoma that became a sporadic adenocarcinoma in a patient with longstanding CD. To the best of our knowledge, this is the first report of colitis-associated cancer in a patient with CD after removal of a sporadic cancer.

Case presentation: We describe a 51-year old man with CD who had difficulty in defecation. A rectal polyp was detected and a transanal resection of the polyp was performed. A histopathological examination showed an adenoma with sporadic adenocarcinoma. After three years, a follow-up colonoscopy revealed a reddish, elevated lesion in the patient's rectum. A colonoscopic biopsy showed a signet ring cell carcinoma. We performed an abdominoperineal resection of the rectum and a bilateral pelvic lymph node dissection. A histopathological examination revealed a mucinous adenocarcinoma with signet ring cell carcinoma and lymph node metastasis. The patient received adjuvant chemotherapy with oral uracil 224 mg combined with tegafur 100 mg plus leucovorin. No signs of recurrence were noted at a follow-up 18 months after the third surgery and 60 months after the second surgery.

Show MeSH

Related in: MedlinePlus

Histological image of a postoperative specimen shows a mucinous adenocarcinoma with signet ring cell carcinoma. (×200, H & E stain).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4225674&req=5

Figure 7: Histological image of a postoperative specimen shows a mucinous adenocarcinoma with signet ring cell carcinoma. (×200, H & E stain).

Mentions: Three years after the second surgery, in August 2011, colonoscopy examination revealed a reddish, elevated lesion in the rectum (Figure 5). This lesion was located at a different site from the initial lesion. A colonoscopic biopsy revealed a signet ring cell carcinoma. We performed an abdominoperineal resection of the rectum and a bilateral pelvic lymph node dissection (Figure 6). Postoperative histological examination showed a mucinous adenocarcinoma with signet ring cell carcinoma and lymph node metastasis (Figure 7). Dysplasia was detected in the rectal mucosa, and the crypt base was immunohistochemically stained with p53. These findings were consistent with colitis-associated CRC (Figure 8).


Metachronous, colitis-associated rectal cancer that developed after sporadic adenocarcinoma in an adenoma in a patient with longstanding Crohn's disease: a case report.

Takeyama H, Mizushima T, Nakajima K, Uemura M, Haraguchi N, Nishimura J, Hata T, Takemasa I, Yamamoto H, Doki Y, Mori M - World J Surg Oncol (2013)

Histological image of a postoperative specimen shows a mucinous adenocarcinoma with signet ring cell carcinoma. (×200, H & E stain).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4225674&req=5

Figure 7: Histological image of a postoperative specimen shows a mucinous adenocarcinoma with signet ring cell carcinoma. (×200, H & E stain).
Mentions: Three years after the second surgery, in August 2011, colonoscopy examination revealed a reddish, elevated lesion in the rectum (Figure 5). This lesion was located at a different site from the initial lesion. A colonoscopic biopsy revealed a signet ring cell carcinoma. We performed an abdominoperineal resection of the rectum and a bilateral pelvic lymph node dissection (Figure 6). Postoperative histological examination showed a mucinous adenocarcinoma with signet ring cell carcinoma and lymph node metastasis (Figure 7). Dysplasia was detected in the rectal mucosa, and the crypt base was immunohistochemically stained with p53. These findings were consistent with colitis-associated CRC (Figure 8).

Bottom Line: Colorectal cancer associated with Crohn's disease (CD) is increasing in proportion to the number of patients with CD in Japan.The patient received adjuvant chemotherapy with oral uracil 224 mg combined with tegafur 100 mg plus leucovorin.No signs of recurrence were noted at a follow-up 18 months after the third surgery and 60 months after the second surgery.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamada-Oka, Suita, Osaka 565-0871, Japan. tmizushima@gesurg.med.osaka-u.ac.jp.

ABSTRACT

Background: Colorectal cancer associated with Crohn's disease (CD) is increasing in proportion to the number of patients with CD in Japan. There are two subtypes of colorectal cancer with CD: sporadic cancer and colitis-associated cancer. Early diagnosis of colitis-associated cancer is sometimes difficult; when colorectal cancer is found in patients with CD, both colitis-associated cancer and sporadic cancer should be kept in mind. Here, we describe a case of metachronous, colitis-associated rectal cancer that developed after the complete resection of an adenoma that became a sporadic adenocarcinoma in a patient with longstanding CD. To the best of our knowledge, this is the first report of colitis-associated cancer in a patient with CD after removal of a sporadic cancer.

Case presentation: We describe a 51-year old man with CD who had difficulty in defecation. A rectal polyp was detected and a transanal resection of the polyp was performed. A histopathological examination showed an adenoma with sporadic adenocarcinoma. After three years, a follow-up colonoscopy revealed a reddish, elevated lesion in the patient's rectum. A colonoscopic biopsy showed a signet ring cell carcinoma. We performed an abdominoperineal resection of the rectum and a bilateral pelvic lymph node dissection. A histopathological examination revealed a mucinous adenocarcinoma with signet ring cell carcinoma and lymph node metastasis. The patient received adjuvant chemotherapy with oral uracil 224 mg combined with tegafur 100 mg plus leucovorin. No signs of recurrence were noted at a follow-up 18 months after the third surgery and 60 months after the second surgery.

Show MeSH
Related in: MedlinePlus