[Intestinal carcinoma in Crohn's disease. Report of four cases and review of the literature].
BACKGROUND
Increasing numbers of intestinal carcinomas in patients affected by Crohn's disease have been reported by several authors, even if the strength of this associations (age, longstanding of the disease, its characteristics and distribution) still has to be elucidated.


METHODS
From January 1992 to July 2000, 130 patients with Crohn's disease were submitted to surgery.


RESULTS
Four patients showed an associated intestinal carcinoma at operation, in 3 cases located in the ileum, and in 1 case in the colon. Patients' mean age was 54 years. Mean duration time of the Crohn's disease was 7 years. One patient died 3 months after surgery for disseminated peritoneal carcinomatosis, whereas 3 patients are still alive with malignancy free at 5, 8, and 11 years after the tumor resection.


CONCLUSIONS
These results suggest the difficulty in recognizing patients with Crohn's disease who are at risk for intestinal carcinoma. Longstanding disease, previous intestinal exclusion surgery, enterocutaneous or other types of fistulas should be considered for the development of cancer. Therefore, the prognosis may be good if early diagnosis and treatment are made.
Prati
M
M
Dipartimento di Scienze Chirurgiche, II Divisione di Chirurgia Generale, Università degli Studi, Ospedale Maggiore Policlinico IRCCS, Milan, Italy.
Quadri
F
F
Botti
F
F
Carrara
A
A
De Simone
M
M
Cioffi
U
U
Contessini Avesani
E
E
D000368:Aged; D002648:Child; D003110:Colonic Neoplasms / Q000209:etiology* / Q000601:surgery; D003424:Crohn Disease / Q000150:complications*; D005260:Female; D006801:Humans; D007078:Ileal Neoplasms / Q000209:etiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged