Abstract
Patients with carcinoma involving chronic fistulizing Crohn's disease may have developed the malignancy due to chronic epithelial irritation at either end of the fistula tract. Alternatively, the carcinoma may be the cause of the fistula. Examples of each type of relationship are presented in the reports of four patients from our institution and supported by a review of the literature. The diagnoses of such carcinomas are often delayed due to lack of specificity of symptoms and signs. A high index of suspicion and regular surveillance of high-risk patients are recommended.
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References
Hughes RK. Reticulum cell carcinoma: a case possibly originating in an area of regional enteritis. Am Surg 1955;21:770.
Ginzburg L, Schneider KM, Dreizin DH, Levinson C. Carcinoma of the jejunum occurring in a case of regional enteritis. Surgery 1956;39:347–51.
Korelitz BI. Carcinoma of the intestinal tract in Crohn's disease: results of a survey conducted by the National Foundation for Ileitis and Colitis. Am J Gastroenterol 1983;78:44–6.
Greenstein AJ, Sacher D, Pucillo A, et al. Cancer in Crohn's disease after diversionary surgery. Am J Surg 1978;135:86–90.
Traube J, Simpson S, Riddell RH, Levin B, Kirsner JB. Crohn's disease and adenocarcinoma of the bowel. Dig Dis Sci 1980; 25:939–44.
Cooper DJ, Weinstein MA, Korelitz BI. Complications of Crohn's disease predisposing to dysplasia and cancer of the intestinal tract: considerations of a surveillance programme. J Clin Gastroenterol 1984;6:217–24.
Lightdale CJ, Sternberg SS, Posner G, Sherlock P. Carcinoma complicating Crohn's disease. Am J Med 1975;59:262–8.
Wein MA, Spector N, Robinson HM. Regional ileitis complicated by adenocarcinoma. Am J Gastroenterol 1964;41:58–63.
Kim U, Aufses AH Jr, Kreel I. Malignant tumors associated with granulomatous enteritis. Am J Gastroenterol 1975;63:66–70.
Kerber GW, Frank PH. Carcinoma of the small intestine and colon as a complication of Crohn's disease: radiologic manifestations. Radiology 1984;150:639–45.
Burbige EJ, Bedine MS, Handelsman JC. Adenocarcinoma of the small intestine in Crohn's disease involving the small bowel. West J Med 1977;127:43–5.
Kipping RA. Crohn's disease of the colon with carcinoma of the rectum. Proc R Soc Med 1970;63:753.
Weingarten B, Wein J. Malignant degeneration in chronic inflammatory disease of the colon and small intestine. Am J Gastroenterol 1960;33:203.
Jones JH. Colonic cancer and Crohn's disease. Gut 1969;10:651–4.
Buchanan P, Allan RN, Thompson H, Alexander-Williams J. Carcinoma in a rectovaginal fistula in a patient with Crohn's disease. Am J Surg 1980;140:462–3.
Preston DM, Fowler EF, Lennard-Jones JE, Hawley PR. Carcinoma of the anus in Crohn's disease. Br J Surg 1983;70:346–7.
Slater G, Greenstein A, Aufses AH. Anal carcinoma in patients with Crohn's disease. Ann Surg 1984;199:348–50.
Chaikhouni A, Regueyra FI, Stevens JR. Adenocarcinoma in perineal fistulas of Crohn's disease. Dis Colon Rectum 1981; 24:639–43.
Daly JJ, Madrazo A. Anal Crohn's disease with carcinoma in situ. Dig Dis Sci 1980;25:464–6.
Arons MD, Lynch JB, Lewis SR, Blocker TG. Scar tissue carcinoma. Part I: a clinical study with special reference to burn scar carcinoma. Ann Surg 1965;161:170–88.
Cruickshank AH, McConnell EM, Miller DG. Malignancy in scars, chronic ulcers and sinuses. J Clin Pathol 1963;16:573–80.
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Church, J.M., Weakley, F.L., Fazio, V.W. et al. The relationship between fistulas in Crohn's disease and associated carcinoma. Dis Colon Rectum 28, 361–366 (1985). https://doi.org/10.1007/BF02560444
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DOI: https://doi.org/10.1007/BF02560444