COLONIC PRE-CANCER IN CROHNS-DISEASE

  • 1 January 1981
    • journal article
    • research article
    • Vol. 80  (3) , 578-584
Abstract
Two patients with longstanding Crohn''s disease, who developed colonic carcinoma and showed associated precancer identical to that seen with ulcerative colitis, are reported. The 1st patient developed rectal adenocarcinoma at age 42 yr, 27 yr after the onset of symptoms while the 2nd patient had a clinically silent, small colonic carcinoma at the time of colectomy, 40 yr after the onset of disease. Both patients had characteristic Crohn''s disease. In both patients, in addition to the carcinoma, there was multifocal precancer characterized by epithelial dysplasia and adenomatous growth pattern and villiform proliferation of the mucosa. These changes were identical to those associated with ulcerative colitis and, the 2 cases, were present adjacent to and distant from the infiltrating carcinomas. Such epithelial changes, termed precancer in the setting of longstanding ulcerative colitis, can also occur in association with longstanding Crohn''s disease. Further studies are needed to define the incidence of such precancerous changes in Crohn''s disease more clearly and to evaluate the relationship between these changes and carcinoma. Careful evaluation of patients with longstanding Crohn''s disease and precancer is warranted to exclude concomitant carcinoma.