Abstract
Two cases of carcinoma in Crohn's disease of the colon are reported. One patient was a 30-year-old man who had asymptomatic Crohn's ileocolitis resulting in an acute presentation due to toxic dilatation of the colon. This was preceded by a short prodromal period of four weeks, characterized by intermittent diarrhea on the basis of a coloileal tumor fistula. A mucus-secreting adenocarcinoma was present in the sigmoid colon associated with both adjacent and one nearby focus of high-grade mucosal dysplasia. Pelvic wall and abdominal metastases were present, and the patient died two months later. The other patient was a 60-year-old woman who had a nine-year history of biopsy-proven Crohn's proctocolitis. A stricture of the sigmoid colon due to Crohn's disease also harbored an invasive adenocarcinoma. The carconima was not evident preoperatively or on initial gross pathologic examination. The presentation and pathology of large intestinal carcinoma in Crohn's colitis are discussed and illustrated.
Similar content being viewed by others
References
Butt JH, Lennard-Jones JE, Ritchie JK. A practical approach to the risk of cancer in inflammatory bowel disease. Med Clin North Am 1980;64:1203–20.
Greenstein AJ, Sachar DB, Smith H, Janowitz HD, Aufses AH Jr. Patterns of neoplasia in Crohn's disease and ulcerative colitis. Cancer 1980;46:403–7.
Gyde SN, Prior P, Macartney JC, Thompson H, Waterhouse JA, Allan RN. Malignancy in Crohn's disease. Gut 1980;21:1024–9.
Weedon DD, Shorter RG, Ilstrup DM, Huizenga KA, Taylor WF. Crohn's disease and cancer. N Engl J Med 1973;289:1099–103.
Hamilton SR. Colorectal carcinoma in patients with Crohn's disease. Gastroenterology 1985;89:398–407.
Glotzer DJ. The risk of cancer in Crohn's disease (editorial). Gastroenterology 1985;89:438–41.
Morson BC, Dawson IM. Gastrointestinal pathology. 2nd ed. Oxford: Blackwell Scientific Publications, 1979.
Price AB. Overlap in the spectrum of nonspecific inflammatory bowel disease: colitis indeterminate. J Clin Pathol 1978;31:567–77.
Edwards FC, Truelove SC. The course and prognosis of ulcerative colitis. Gut 1964;5:1–15.
Riddell RH. The precarcinomatous phase of ulcerative colitis. In: Morson BC, ed. Current topics in pathology of the gastrointestinal tract, Berlin: Springer, 1976:179–219.
Heimann TM, Greenstein AJ, Bolnick K, Yoelson S, Aufses AH Jr. Colorectal cancer in familial polyposis coli and ulcerative colitis. Dis Colon Rectum 1985;28:658–61.
Humphreys WG, Parks TG. Crohn's disease in Northern Ireland: a retrospective survey of 159 cases. Ir J Med Sci 1975;144:437–46.
Morson BC. Cancer in ulcerative colitis. Gut 1966;6:425–6.
Allen DC, Biggart JD, Pyper PC. Large bowel mucosal dysplasia and carcinoma in ulcerative colitis. J Clin Pathol 1985;38:30–43.
Lennard-Jones JE, Morson BC, Ritchie JK, Shove DC, Williams CB. Cancer in colitis: assessment of the individual risk by clinical and histological criteria. Gastroenterology 1977;73:1280–9.
Bearzi I, Ranaldi R. Small bowel adenocarcinoma and Crohn's disease: report of a case with differing histogenetic patterns. Histopathology 1985;9:345–7.
Simpson S, Traube J, Riddell RH. The histologic appearance of dysplasia (percarcinomatous change) in Crohn's disease of the small and large intestine. Gastroenterology 1981;81:492–501.
Muto T, Bussey HJ, Morson BC. The evolution of cancer of the colon and rectum. Cancer 1975;36:2251–70.
Morson BC, Pang LS. Rectal biopsy as an aid to cancer control in ulcerative colitis. Gut 1967;8:423–34.
Riddell RH, Goldman H, Ransohoff DF, et al. Dysplasia in inflammatory bowel disease: standardized classification with provisional clinical applications. Hum Pathol 1983;14:931–68.
Greaves P, Filipe MI, Abbas S, Ormerod MG. Sialomucins and carcinoembryonic antigen in the evolution of colorectal cancer. Histopathology 1984;8:825–34.
Allen DC, Biggart JD, Orchin JC, Foster H. An immunoperoxidase study of epithelial marker antigens in culcerative colitis with dysplasia and carcinoma. J Clin Pathol 1985;38:18–29.
Isaacson P. Immunoperoxidase study of the secretory immunoglobulin system in colonic neoplasia. J Clin Pathol 1982;35:14–25.
Rognum TO, Elgjo K, Fausa O, Brandtzaeg P. Immunohistochemical evaluation of carcinoembryonic antigen, secretory component, and epithelial IgA in ulcerative colitis with dysplasia. Gut 1982;23:123–33.
Dickinson RJ, Dixon MF, Axon AT. Colonscopy and the detection of dysplasia in patients with longstanding ulcerative colitis. Lancet 1980;2:620–2.
Lennard-Jones JE, Morson BC, Ritchie JK, Williams CB. Cancer surveillance in ulcerative colitis: experience over 15 years. Lancet 1983;2:149–52.
Allen DC, Biggart JD. Misplaced epithelium in ulcerative colitis and Crohn's disease of the colon and its relationship to malignant mucosal changes. Histopathology 1986;10:37–52.
Keighley MR, Thompson H, Alexander-Williams J. Multifocal colonic carcinoma and Crohn's disease. Surgery 1975;78:534–7.
Isaacson P, Wright DH. Malignant histiocytosis of the intestine: its relationship to malabsorption and ulcerative jejunitis. Hum Pathol 1978;9:661–77.
Greenstein AJ, Sachar D, Pucillo A, et al. Cancer in Crohn's disease after diversionary surgery: a report of seven carcinomas occurring in excluded bowel. Am J Surg 1978;135:86–90.
Thompson EM, Clayden G, Price AB. Cancer in Crohn's disease: an ‘occult’ malignancy. Histopathology 1983;7:365–76.
Fleming KA, Pollock AC. A case of ‘Crohn's carcinoma.’ Gut 1975;15:533–7.
Elliott PR, Richie JK, Lennard-Jones JE. Prognosis of colonic Crohn's disease. Br Med J 1985;291:178.
Author information
Authors and Affiliations
Additional information
No reprints will be available.
About this article
Cite this article
Allen, D.C., Hughes, D.F. & Calvert, C.H. Carcinoma in Crohn's disease of the colon. Dis Colon Rectum 29, 760–765 (1986). https://doi.org/10.1007/BF02555329
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF02555329