title: Metastatic colon cancer mimicking Crohn's disease.
abstract: A 66-year-old Japanese woman presented with intestinal obstruction and right-sided hydronephrosis. Although upper gastrointestinal endoscopy demonstrated signet-ring cell gastric carcinoma, colonoscopy and barium enema study yielded findings mimicking Crohn's disease in the colon, that is, skipping longitudinal ulcer scarlike strictures, cobblestone appearance, segmental stricture, and pseudosacculations. After total gastrectomy and right-sided hemicolectomy, the final diagnosis of gastric cancer extensively involving the colon, and not of Crohn's disease complicating gastric cancer, was established. Pathologic examination showed that anaplastic cancer with exuberant desmoplastic reaction and infiltration along the mesenteric border principally accounted for the morphological similarities noted between Crohn's disease and metastatic colon cancer in this case. The findings in the present case, together with a review of the literature, suggest that metastatic colon cancer should be considered when Crohn-like colonic findings are encountered, not only in individuals with concurrent cancer in other sites but also in those with distant history of cancer.
authors.affiliation: Department of Internal Medicine, Kanazawa Social Insurance Hospital, Kanazawa 920-8610, Japan. zenzen@spacelan.ne.jp
authors.forename: Takahiro
authors.initials: T
authors.lastname: Zenda
authors.forename: Keizo
authors.initials: K
authors.lastname: Taniguchi
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Takeshita
authors.forename: Syuichi
authors.initials: S
authors.lastname: Choto
authors.forename: Takaharu
authors.initials: T
authors.lastname: Masunaga
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Minato
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000556:secondary* / Q000601:surgery; D000368:Aged; D001466:Barium Sulfate; D003082:Colectomy; D003110:Colonic Neoplasms / Q000150:complications / Q000556:secondary* / Q000601:surgery; D003113:Colonoscopy; D003424:Crohn Disease / Q000473:pathology*; D003937:Diagnosis, Differential; D004733:Enema; D005260:Female; D005743:Gastrectomy; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology; D007415:Intestinal Obstruction / Q000209:etiology; D013274:Stomach Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed
chemical_list: D001466:Barium Sulfate