Synchronous adenocarcinoma and carcinoid tumor of the terminal ileum in a Crohn's disease patient.
BACKGROUND
Several malignancies have been described in association with inflammatory bowel diseases, the most common being adenocarcinoma. Carcinoid tumor and Crohn disease has also been previously reported, however the coexistence of both neoplasms is quite rare and the clinical diagnosis is very difficult. Here we report what we believe to be the fourth case of a mixed adenocarcinoid tumor coexisting with Crohn's disease.


METHODS
The patient presented with clinical and radiological features of intestinal obstruction. Laparotomy showed a stricturing lesion in the last 6 cm of the terminal ileum with proximal dilation. Only the histology of the resected surgical specimen proved the presence of a mixed adenocarcinoid tumor involving the terminal ileum.


CONCLUSIONS
Carcinoid tumor should be suspected in elderly patients with Crohn's disease presenting with intestinal obstruction and laparotomy should be considered to exclude malignancy.
Cioffi
Ugo
U
Department of Surgery, University of Milan, Fondazione Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, IRCCS, Milan, Italy. ugo.cioffi@unimi.it
De Simone
Matilde
M
Ferrero
Stefano
S
Ciulla
Michele M
MM
Lemos
Alessandro
A
Avesani
Ettore Contessini
EC
D000230:Adenocarcinoma / Q000150:complications* / Q000175:diagnosis; D002276:Carcinoid Tumor / Q000150:complications* / Q000175:diagnosis; D053379:Chromogranin A; D002864:Chromogranins / Q000378:metabolism; D003424:Crohn Disease / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D007078:Ileal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D007082:Ileum / Q000473:pathology; D007150:Immunohistochemistry; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000175:diagnosis*
D053379:Chromogranin A; D002864:Chromogranins