Adenocarcinoma in Crohn’s disease: the pathologist’s experience in a tertiary referral centre of inflammatory bowel disease

Malvi, Deborah; Vasuri, Francesco; Mattioli, Benedetta; Gruppioni, Elisa; Fiorentino, Michelangelo; Gionchetti, Paolo; Grigioni, W.; Poggioli, Gilberto; D’Errico-Grigioni, Antonia

doi:10.1097/pat.0000000000000123

Cited by 6 publications

(6 citation statements)

References 30 publications

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“…39 Against this background, it is of particular interest that none of the MACs identified in CD in the presented study displayed MSI. The study by Malvi et al 13 on 5 fistula-in-ano cancers had the same findings. However, the description of a clearly increased rate of MAC and SRCC in CD patients with colon or rectal cancer and the correlation to a so far not explainable high rate of MSS in both colon and rectal cancer has not been made yet.…”

Section: Discussionsupporting

confidence: 59%

“…In a recently published study of 5 colorectal adenocarcinomas in CD patients all showed mucinous histopathology. 13 However, in this study all patients had in the past already undergone total colectomy and then had a fistula-in-ano cancer. The significantly higher number of MAC on the basis of chronic perianal fistula is known.…”

Section: Discussionmentioning

confidence: 87%

“…Several publications have reported a higher percentage of MAC in CD patients with CRC; however, the magnitude of this varies considerably. [11][12][13] Signet ring cell carcinoma (SRCC) is a less frequent entity. The WHO describes SRCC as a carcinoma composed of >50% signet ring cells, which are defined by an accumulation of intracellular mucin.…”

Section: Histologic Subtypes Of Colorectal Adenocarcinomamentioning

confidence: 99%

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Clinical and Histopathologic Features of Colorectal Adenocarcinoma in Crohn’s Disease

Galata¹,

Hirsch

Reindl

et al. 2018

Journal of Clinical Gastroenterology

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Our data indicate that CRCs with signet ring cell and mucinous components were much more common in patients with CD than in patients with sporadic CRC. This observation suggests that CRC in CD represent an own entity with distinct histopathologic and molecular features. This may implicate potential consequences for diagnosis and therapy of CRC in CD in the future as well as new factors to identify patients with an increased risk for developing CRC in CD.

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 87%

Section: Histologic Subtypes Of Colorectal Adenocarcinomamentioning

confidence: 99%

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Clinical and Histopathologic Features of Colorectal Adenocarcinoma in Crohn’s Disease

Galata¹,

Hirsch

Reindl

et al. 2018

Journal of Clinical Gastroenterology

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“…1). Twenty articles (15 case reports and five case series) were included for subsequent bias assessment (Supplementary Material 1, 2, www.wjon.org) [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. Two case reports were deemed high risk for bias, while the remaining articles were all rated as moderate risk for bias (Supplementary Material 1, 2, www.wjon.org).…”

Section: Systematic Review Of Crohn's Disease Patients With Srccmentioning

confidence: 99%

“…In summary, the 20 articles included 40 patients with both Crohn's disease and a diagnosis of small bowel SRCC, with nearly all cases arising in the distal/terminal ileum (Table 1) [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. Patients presented at an approximate mean age of 59 years old, with a range from 31 to 76.…”

Section: Systematic Review Of Crohn's Disease Patients With Srccmentioning

confidence: 99%

Malignant Transformation of Long-Standing Ileal Crohn’s Disease Likely Favors Signet Ring Cell Adenocarcinoma Histology

Benesch,

Nelson,

O’Brien

2023

World J Oncol

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Signet ring cell adenocarcinomas (SRCCs) are a rare and aggressive histological subtype of adenocarcinomas typically with poor prognosis usually secondary to late stage at detection. In the small bowel, they constitute only 1% of all malignancies. In the last decade, there have been multiple case reports and small case series that have identified SRCCs, typically in the ileum, in patients with Crohn's disease. Crohn's disease is a transmural inflammatory condition that normally manifests in the distal ileum and colon, and is known to temporally increase the risk of malignancy. Given the profound rarity of SRC-Cs, establishing an association between Crohn's disease and SRCC is challenging. In this study, we performed a systematic review of case reports and small case series describing small bowel SRCCs in Crohn's disease patients. Most cases were found in the distal/terminal ileum, at a mean age of 59 years old. Virtually all tumors were locally advanced (pathological T stage 3 and 4), typically with at least N1 nodal disease. Two case studies (one is a case-control study and the other a cohort design) demonstrated that small bowel SRCC, as opposed to conventional adenocarcinoma, was significantly correlated to a history of Crohn's disease (35% vs. 0%, 73.5% vs. 28.5%), with a propensity to arise in the ileum (95% vs. 30%, 66.7% vs. 42.1%), and at earlier mean age (43 vs. 68 years, 53.7 vs. 61.7 years). We additionally used the Surveillance, Epidemiology, and End Results (SEER) database for insights into the clinicoepidemiological characteristics of ileum SRCCs. SRCCs composed 28.1% of all ileal SRC-Cs, compared to 11.0% for the adenocarcinomas, with a younger age at diagnosis (60.7 vs. 64.6 years), more distant disease at presentation (41.3% vs. 26.4%), and shorter overall median survival time (20 vs. 39 months). In summary, while there is limited direct evidence to support an association between small bowel SRCC and Crohn's disease, the phenomenon has been increasingly documented in the literature in the last decade. Clinicians treating Crohn's disease patients should consider this in their differential diagnosis, particularly when managing disease complications, as early detection and surgical intervention offer the best prognosis.

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Inflammatory Bowel Disease and Small Bowel Cancer Risk, Clinical Characteristics, and Histopathology: A Population-Based Study

Bojesen

Riis

Høgdall

et al. 2017

Clinical Gastroenterology and Hepatology

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Adenocarcinoma in Crohn’s disease: the pathologist’s experience in a tertiary referral centre of inflammatory bowel disease

Cited by 6 publications

References 30 publications

Clinical and Histopathologic Features of Colorectal Adenocarcinoma in Crohn’s Disease

Clinical and Histopathologic Features of Colorectal Adenocarcinoma in Crohn’s Disease

Malignant Transformation of Long-Standing Ileal Crohn’s Disease Likely Favors Signet Ring Cell Adenocarcinoma Histology

Inflammatory Bowel Disease and Small Bowel Cancer Risk, Clinical Characteristics, and Histopathology: A Population-Based Study

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