Synchronic signet ring carcinoma and adenocarcinoma complicating extensive and long-standing ulcerative colitis.
We report the case of a 38 year-old woman with extensive ulcerative colitis (UC) for 9 years that had consistently been under close endoscopic surveillance. She had had two previous severe attacks requiring hospital admission, with good response to intravenous steroids. In the last relapse, a total colonoscopy demonstrated extensive lesions of UC throughout the entire colon. Multiple biopsies taken every 3 cm revealed only low-grade dysplasia and lesions characteristic of UC. Due to medical therapy failure, the patient was submitted for proctocolectomy. Pathological examination of the resected specimen showed a signet ring carcinoma and a synchronic adenocarcinoma in the sigmoid colon, both undetected by colonoscopy and biopsies. The issue of surveillance in patients with extensive and long-standing UC is discussed.
Pontes
J
J
Hospital Geral, Centro Hospitalar De Coimbra, Portugal.
Fernandes
C
C
Panao
E
E
Castro
L
L
Vicente
L
L
Neto
M
M
Campos
M
M
Pontes
F
F
D000230:Adenocarcinoma / Q000150:complications* / Q000473:pathology; D000328:Adult; D018279:Carcinoma, Signet Ring Cell / Q000150:complications* / Q000473:pathology; D003093:Colitis, Ulcerative / Q000150:complications* / Q000473:pathology; D003110:Colonic Neoplasms / Q000150:complications* / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D009378:Neoplasms, Multiple Primary / Q000150:complications* / Q000473:pathology