Intestinal cancer in Crohn's disease.
OBJECTIVE
We investigated Crohn's Disease (CD) patients with carcinomas in the intestinal tract to emphasize the difficulty in establishing a diagnosis, as well as show the importance of establishing formal guidelines for screening and surveillance of cancers associated with perianal CD.


METHODS
We studied 504 CD patients treated in our department with surgical intervention.


RESULTS
In 9 of the patients, carcinomas developed in relation to CD, 7 of whom had cancer of the lower rectum and anus with severe anorectal CD lesions. Five of 6 patients with advanced carcinoma in the anorectal region were treated using preoperative chemoradiation therapy and all 7 with anorectal carcinomas underwent an abdominoperineal resection. Two patients with a carcinoma of the fistula in the ileo-rectum or ileo-sigmoid colon were treated by a partial resection of the small and large bowel with the fistula. Mucinous cell type carcinomas were present in 6 patients, while signet ring cell type was found in 2 patients and poorly differentiated adenocarcinoma in 1. Three died prior to the follow-up examination.


CONCLUSIONS
There was an increased incidence of carcinoma in the intestinal tracts of patients with CD. It is important to establish a surveillance program for CD patients, especially those complicated with severe anorectal CD lesions.
Ikeuchi
Hiroki
H
Department of Surgery, Hyogo College of Medicine, Hyogo, Japan. ikeuci2s@hyo-med.ac.jp
Nakano
Hiroki
H
Uchino
Motoi
M
Nakamura
Mitsuhiro
M
Matsuoka
Hiroki
H
Fukuda
Yoshihiro
Y
Matsumoto
Takayuki
T
Takesue
Yoshio
Y
Tomita
Naohiro
N
D000328:Adult; D003424:Crohn Disease / Q000150:complications*; D005260:Female; D006801:Humans; D007414:Intestinal Neoplasms / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D049268:Positron-Emission Tomography; D012189:Retrospective Studies