Crohn's disease-associated colorectal cancer in Japan: report of four cases.
OBJECTIVE
We report four cases of Crohn's disease (CD)-associated colorectal cancer (CRC) in our department. CASE 1: A 42-year-old Japanese man had a 14-year history of ileocolon CD. He had a history of an ileocecal resection and a stricture plasty. At the age of 42, sigmoid colostomy was performed because of the deterioration of the anal stenosis. After this operation, the perianal pain had remained, and a magnetic resonance imaging scan revealed a rectal tumor. CASE 2: A 30-year-old Japanese man had a 13-year history of ileocolon CD. He had a history of an ileostomy, a subtotal colectomy, and ileo-rectal anastomosis. At the age of 30, he had perianal pain, and a colonoscopy revealed a rectal cancer. An abdomino-perineal resection of the remnant rectum was performed. CASE 3: A 46-year-old Japanese man had a 9-year history of ileocolon CD. He experienced abdominal fullness. Colonoscopy revealed an ascending colon cancer. He underwent a subtotal colectomy and ileo-rectal anastomosis. CASE 4: A 33-year-old Japanese woman had a 16-year history of ileocolon CD. She had no changes in symptoms of CD. Surveillance colonoscopy revealed a transverse colon cancer. She underwent a subtotal colectomy and ileo-rectal anastomosis.


CONCLUSIONS
As the number of patients with CD and with CD-associated CRC has increased in Japan, CD-associated CRC, as noted in these patients, should be kept in mind in the management of patients with CD. In addition, a surveillance system of patients with CD should be established and should prompt further study about CD-associated CRC.
Hayashi
Tadataka
T
Second Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan. thayashi@hama-med.ac.jp
Nakamura
Toshio
T
Kurachi
Kiyotaka
K
Fukazawa
Atsuko
A
Nakajima
Akihito
A
Nakamura
Koichi
K
Suzuki
Shohachi
S
Konno
Hiroyuki
H
D000328:Adult; D000714:Anastomosis, Surgical; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D003125:Colostomy; D003424:Crohn Disease / Q000150:complications* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007081:Ileostomy; D007564:Japan; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography
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