AIMS: 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. METHODOLOGY: 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.
AIMS: 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. METHODOLOGY: We studied 504 CDpatients 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 CDpatients, especially those complicated with severe anorectal CD lesions.
Authors: T Hussain; N A Jeganathan; G Karagkounis; L Stocchi; S Shawki; S D Holubar; I Gordon; T Hull; D Liska Journal: Tech Coloproctol Date: 2020-06-28 Impact factor: 3.781