Gastrointestinal malignancies in Crohn's disease

Savoca, Paul; Ballantyne, Garth H.; Cahow, C E

doi:10.1007/bf02053192

Cited by 66 publications

(25 citation statements)

References 21 publications

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“…In 2 of them the diagnosis of concurrently existing carcinoma of the large bowel and Crohn’s disease was suspected at the operation table and was confirmed histologically by the operative specimen. It seems that the incidence, characteristics and prognosis of colorectal carcinoma complicating Crohn’s disease are similar to the features of cancer complicating ulcerative colitis including young age and long duration of disease [42, 43]. Review of the literature indicated that 191 of the 295 cases (64.8%) of colorectal carcinomas in Crohn’s disease reported so far occurred in the past 7 years [44].…”

Section: Discussionmentioning

confidence: 99%

Clinical Patterns of Crohn’s Disease in Greece: A Follow-Up Study of 155 Cases

Triantafillidis

Emmanouilidis²,

Manousos³

et al. 2000

Digestion

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The aim of this prospective study was to elucidate the clinical features and natural history of Crohn’s disease in Greece. One hundred and fifty-five Greek patients with definite diagnosis of Crohn’s disease were followed-up for a mean period of 9.7 years and evaluated for clinical patterns and course of illness. The male/female ratio was 1.58:1. The peak incidence of the disease was observed between 20 and 30 years of age. The majority of patients were urban dwellers and of higher socio-economic level compared to the general population of Greece. In almost 50% of the patients symptoms of the disease started below the age of 30, although in almost one in every 5 cases, symptoms appeared after the age of 50. Familial clustering of inflammatory bowel disease was observed in 1.3%. The pattern of anatomic involvement was: ileocolic 33.3%, colon 33.3% and small bowel 33.3%. The kind of predominant symptoms at the time of diagnosis was related to the anatomic location of the disease. At least one extraintestinal manifestation appeared in 42% of patients. Perianal disease was noticed in 21.3% with fistulae and abscesses being the most common manifestation. Fifty-one percent of patients were operated upon at least once during the follow-up period because of acute abdomen, bad response to conservative treatment and fistulae and abscesses. Emergency operation was required in 17.3% of the patients. Evolution to cancer was observed in 3 patients (2%). During the follow-up period of 9.7 ± 6.5 years, 18 patients (11.6%) died. A considerable mortality was noticed in the surgically treated group of patients, while in the nonoperated group the disease was running with milder symptoms. It is concluded that some of the clinicoepidemiological characteristics of patients with Crohn’s disease in Greece are in accordance with those reported from western as well as the neighboring Mediterranean countries. However, other parameters such as the higher incidence of the disease in males, the low incidence of familial clustering, and the low incidence of perianal disease, underline the importance of environmental, genetic and other factors on the evolution and behavior of the disease in different parts of the world.

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Section: Discussionmentioning

confidence: 99%

Clinical Patterns of Crohn’s Disease in Greece: A Follow-Up Study of 155 Cases

Triantafillidis

Emmanouilidis²,

Manousos³

et al. 2000

Digestion

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“…The association of chronic IBD and gastrointestinal adenocarcinoma is well known [3, 4, 5, 6, 7, 8, 9], and in recent years, some forms of extraintestinal cancer also appeared to be more prevalent in these patients than in the general population [18, 19]. The risk of colorectal carcinoma in patients with ulcerative colitis increases with more extensive bowel involvement and colitis of longer duration.…”

Section: Discussionmentioning

confidence: 99%

“…Crohn’s-associated cancers of the small bowel are mostly adenocarcinomas or lymphomas [4, 5, 8, 9]. In general, these tumors appear to develop at a younger age and have a much graver prognosis than those in patients in whom enteritis is not present [22].…”

Section: Discussionmentioning

confidence: 99%

“…Other primary intestinal tumors are rare in these patients, though a number of cases with gastrointestinal lymphoma [10, 11], carcinoids [8, 12, 13]and, to our knowledge, a total of only 2 patients with sarcomas [14, 15]complicating IBD have been published. Generally, all these tumors occurred in patients with a long history of IBD and were almost exclusively located at the site of granulomatous disease or in bypassed bowel segments.…”

Section: Introductionmentioning

confidence: 99%

“…Since the first 2 case reports of malignant tumors arising in patients with Crohn’s disease by Warren and Sommers [1]in 1948 and Ginzburg et al [2]in 1956, there has been accumulating evidence for an association between intestinal adenocarcinomas and inflammatory bowel disease (IBD) [3, 4, 5, 6, 7, 8, 9]. Other primary intestinal tumors are rare in these patients, though a number of cases with gastrointestinal lymphoma [10, 11], carcinoids [8, 12, 13]and, to our knowledge, a total of only 2 patients with sarcomas [14, 15]complicating IBD have been published.…”

Section: Introductionmentioning

confidence: 99%

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Coincidence of Crohn’s Disease and a High-Risk Gastrointestinal Stromal Tumor of the Terminal Ileum

Pfeffel

Stiglbauer²,

Depisch³

et al. 1999

Digestion

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A 51-year-old male patient presented with characteristic radiologic features of Crohn’s disease in the terminal ileum plus a large tumorous lesion in the right lower abdomen. Because of rapid crescent symptoms of bowel obstruction, the patient underwent surgery revealing a high-risk gastrointestinal stromal tumor (GIST) of the terminal ileum within an area of Crohn’s ileitis. Whereas the association of chronic inflammatory bowel disease (IBD) and gastrointestinal adenocarcinoma is well known, other primary intestinal tumors are rare in these patients, particularly at the time of onset of clinical symptoms. This is the 3rd patient reported in the literature with a sarcoma complicating IBD, and in fact, the first description of the coincidence of Crohn’s disease and GIST. Though the present case is likely to be a mere coincidence of two pathologically distinct entities (without any potential causal relationship), it should remind one of the possibility of small bowel ‘Crohn’s carcinoma’ in patients with a sudden change in symptomatology as well as in those in whom intestinal obstruction fails to resolve with adequate therapy.

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Inflammatory bowel disease and colon cancer

Levin¹

1992

Cancer

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Patients who have had extensive colitis for more than 10 years are at increased risk for colorectal cancer. The risk may be greatest for those whose onset of illness is in childhood. Management options for patients at increased risk include prophylactic colectomy or endoscopic surveillance. The object of surveillance is prevention of cancer by detecting premalignant lesions that predispose to cancer. A less desirable objective is the diagnosis of cancer at an early curable stage. Patients must be well informed about their risk for cancer, the limitations of endoscopic surveillance, and the availability of surgical alternatives. Current endoscopic and pathologic techniques focus on the detection of dysplasia, but newer biomarkers may offer greater sensitivity and specificity in the future.

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Gastrointestinal malignancies in Crohn's disease

Cited by 66 publications

References 21 publications

Clinical Patterns of Crohn’s Disease in Greece: A Follow-Up Study of 155 Cases

Clinical Patterns of Crohn’s Disease in Greece: A Follow-Up Study of 155 Cases

Coincidence of Crohn’s Disease and a High-Risk Gastrointestinal Stromal Tumor of the Terminal Ileum

Inflammatory bowel disease and colon cancer

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