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Carcinoma of the colon and ulcerative colitis

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Summary

The records of 1258 patients with ulcerative colitis who were seen at the Cleveland Clinic in the years 1950 through 1963 were reviewed. Twenty-four cases of carcinoma of the colon were found, an approximate overall incidence of 1.9%. Of these 24 patients, 15 died of the carcinoma; 1 patient died of an unrelated condition, and 8 patients are living and well.

Carcinoma was found to occur in patients with ulcerative colitis at an age earlier than that at which colonic malignant lesions develop in persons without colitis. The mean age of diagnosis of colonic carcinoma was 40.7 years. The mean interval between the onset of colitis and the time of diagnosis of colonic carcinoma was 18.3 years. Ten of the 24 patients had multiple carcinomas, including 3 with multifocal lesions of carcinoma in situ. Of 29 separate carcinomas found, 14 were in the rectosigmoid. The most frequent symptoms of neoplasm simulated those of an exacerbation of the colitis, and included diarrhea, abdominal pain, rectal bleeding, and weight loss. The unreliability of roentgenographic diagnosis of colonic carcinoma in association with colitis was re-emphasized by our study, as 6 of 13 potentially diagnosable lesions were missed. Carcinoma of the colon arising in patients with long-standing ulcerative colitis is a serious hazard, but is not so frequent as has been suspected. However, the physician who treats the patient with ulcerative colitis should be wary of new symptoms and should manage them vigorously with appropriate diagnostic and therapeutic procedures. In this manner, carcinoma may be detected early, and survival rates may be improved.

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References

  1. Crohn, B. B., andRosenberg, H. The sigmoidoscopic picture of ulcerative colitis (nonspecific)Am. J.M. Sc. 170:220, 1925.

    Google Scholar 

  2. Yeomans, F. C. Carcinomatous degeneration of rectal adenomas. Report of 7 cases.J.A.M.A. 89:852, 1927.

    Google Scholar 

  3. Bargen, J. A. Chronic ulcerative colitis complicated by malignant neoplasia.Proc. Staff Meet. Mayo Clin. 3:132, 1928.

    Google Scholar 

  4. Lynn, D. H. The relationship of chronic lesions to carcinoma of the colon—chronic ulcerative colitis. Collective review.Internat. Abstr. Surg. 81:269, 1945.

    Google Scholar 

  5. Weckesser, E. C. andChinn, A. B. Carcinoma of the colon complicating chronic ulcerative colitis.J.A.M.A. 152:905, 1953.

    Google Scholar 

  6. Ricketts, W. E. andPalmer, W. L. Complications of chronic nonspecific ulcerative colitis.Gastroenterology 7:55, 1946.

    Google Scholar 

  7. Kasich, A. M., Weingarten, B., andBrown, M. L. Malignant degeneration in ulcerative colitis. Report of 7 cases.M. Clin. North America 33:1421, 1949.

    Google Scholar 

  8. Gleckler, W. J., andBrown, C. H. Carcinoma of the colon complicating chronic ulcerative colitis.Gastroenterology 14:455, 1950.

    PubMed  Google Scholar 

  9. Sloan, W. P., Jr., Bargen, J. A., andGage, R. P. Symposium on diseases of colon. Life histories of patients with chronic ulcerative colitis. A review of 2000 cases.Gastroenterology 16:25, 1950

    PubMed  Google Scholar 

  10. Cattell, R. B. The surgical treatment of ulcerative colitis.Gastroenterology 10:63, 1948.

    Google Scholar 

  11. Warren, S., andSommers, S. C. Pathology of regional ileitis and ulcerative colitis.J.A.M.A. 154:189, 1954.

    Google Scholar 

  12. Counsell, P. B., andDukes, C. E. The association of chronic ulcerative colitis and carcinoma of rectum and colon.Brit. J. Surg. 39:485, 1952.

    PubMed  Google Scholar 

  13. Felsen, J., andWolarsky, W. Chronic ulcerative colitis and carcinoma.Arch. Int. Med. 84:293, 1949.

    Google Scholar 

  14. Maratka, Z. Ulcerative colitis and carcinoma of the colon.Gastroenterology 40:854, 1961.

    Google Scholar 

  15. Turnbull, R. B., Jr., Fisher, E. R., andRosenack, B. D. Primary linitis plastica carcinoma of the colon.Cleveland Clin. Quart. 18:210, 1951.

    PubMed  Google Scholar 

  16. Farmer, R. G., andBrown, C. H. Colonic carcinoma and ulcerative colitis. Multifocal carcinoma occurring after long remission of colitis.Arch. Int. Med. 113:153, 1964.

    Google Scholar 

  17. Brown, C. H., Diaz, R. J., andMichener, W. M. Carcinoma of the colon and ileum in chronic ulcerative colitis with reflux ileitis.Gastroenterology 47:306, 1964.

    PubMed  Google Scholar 

  18. Ginsburg, L., Schneider, K. M., Dreizin, D. H., andLevinson, C. Carcinoma of the jejunum occurring in a case of regional enteritis.Surgery 39:347, 1956.

    PubMed  Google Scholar 

  19. Kornfeld, P., Ginsburg, L., andAdlersberg, D. Adenocarcinoma occurring in regional jejunitis.Am. J. Med. 23:493, 1957.

    Article  PubMed  Google Scholar 

  20. Bersack, S. R., Howe, J. S., andRehak, E. M. A unique case with roentgenologic evidence of regional enteritis of long duration and histologic evidence of diffuse adenocarcinoma.Gastroenterology 34:703, 1958.

    PubMed  Google Scholar 

  21. Weingarten, B., Parker, J. G., Chazen, E. M., andJacobson, H. G. Adenocarcinoma of the jejunum in nonspecific granulomatous enteritis.Arch. Surg. 78:483, 1959.

    Google Scholar 

  22. Weingarten, B., andWeiss, J. Malignant degeneration in chronic inflammatory disease of the colon and small intestine.Am. J. Gastroenterol. 33:203, 1960.

    PubMed  Google Scholar 

  23. Crohn, B. B., andYarnis, H. Regional Ileitis (ed. 2). Grune, New York, 1958, p. 74.

    Google Scholar 

  24. Hoffert, P. W., Weingarten, B., Friedman, L. B., andMorecki, R. Adenocarcinoma of the terminal ileum in a segment of bowel with coexisting active ileitis.New York J. Med. 63:1567, 1963.

    PubMed  Google Scholar 

  25. Wein, M. A., Spector, N., andRobinson, H. M. Regional ileitis complicated by adenocarcinoma.Am. J. Gastroenterol. 41:58, 1964.

    PubMed  Google Scholar 

  26. Jackman, R. J., Bargen, J. A., andHelmholz, H. F. Life histories of 95 children with chronic ulcerative colitis.Am. J. Dis. Child. 59:459, 1940.

    Google Scholar 

  27. Swinton, N. W., and Counts, R. J. Cancer of the colon and rectum.J.A.M.A. 161:1139, 1956.

    Google Scholar 

  28. Rosenqvist, H., Öhrling, H., Lagercrantz, R., andEdling, N. Ulcerative colitis and carcinoma coli.Lancet 1:906, 1959.

    Google Scholar 

  29. Almy, T. P. Ulcerative colitis.Gastroenterology 41:391, 1961

    PubMed  Google Scholar 

  30. Turell, R.Diseases of the Colon and Anorectum (Vol. II). Saunders, Philadelphia, 1959, p. 658.

    Google Scholar 

  31. Hardy, T. L., andBulmer, E. Ulcerative colitis. Survey of 95 cases.Brit. M.J. 2:812, 1933.

    Google Scholar 

  32. Svartz, N., andGillnäs, T. In which phase of ulcerative colitis does colonic carcinoma occur?Am. J. Digest. Dis. 3:537, 1958.

    Article  PubMed  Google Scholar 

  33. Crile, G., Jr. The treatment of chronic ulcerative colitis.Gastroenterology 23:533, 1953.

    PubMed  Google Scholar 

  34. Shands, W. C., Dockerty, M. B., andBargen, J. A. Adenocarcinoma of large intestine associated with chronic ulcerative colitis.Surg. Gynec. & Obst. 94:302, 1952.

    Google Scholar 

  35. Brooke, B. N. Malignant change in ulcerative colitis.Dis. Colon & Rectum 4:393, 1961.

    Google Scholar 

  36. Kiefer, E. D., andGialanella, R. R. Arrested chronic ulcerative colitis.Gastroenterology 39:687, 1960.

    Google Scholar 

  37. Hodgson, J. R., andSauer, W. G. The roentgenologic features of carcinoma in chronic ulcerative colitis.Am. J. Roentgenol. 86:91, 1960.

    Google Scholar 

  38. Ramsay, G. S. The negative x-ray report in cancer of the colon.Brit. J. Surg. 43:576, 1956.

    PubMed  Google Scholar 

  39. Slaney, G., andBrooke, B. N. Cancer in ulcerative colitis.Lancet 2:694, 1959.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. From the Department of Gastroenterology, The Cleveland Clinic Foundation, Cleveland, Ohio

    Roberto J. Diaz M.D. (Fellow in the Department of Gastroenterology), Richard G. Farmer M.D. & Charles H. Brown M.D.

  2. Cleveland Clinic, USA

    Richard G. Farmer M.D.

Authors
  1. Roberto J. Diaz M.D.
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  2. Richard G. Farmer M.D.
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  3. Charles H. Brown M.D.
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Additional information

A portion of this paper was presented at the fall meeting of the American College of Physicians, Los Angeles, Calif., Oct. 9, 1964.

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Diaz, R.J., Farmer, R.G. & Brown, C.H. Carcinoma of the colon and ulcerative colitis. Digest Dis Sci 10, 643–656 (1965). https://doi.org/10.1007/BF02237639

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