[en] The authors report the case of a 55 yr-old woman suffering from Crohn's disease since 31 years with stricture and fistulas developed in the ileocolic junction and anorectal portion. Long-standing anorectal fistulas and stricture led to adenocarcinoma and finally fistulisation in the vagina. Diagnosis was made by perineal examination with biopsies under general anaesthesia. Treatment was first posterior pelvectomy with resection of the anterior wall of vagina. Secondarily, radiochemotherapy was administrated. The authors discuss the incidence and risk factors of carcinoma in Crohn's disease with chronic fistulas.
Disciplines :
Gastroenterology & hepatology Surgery Oncology
Author, co-author :
Laurent, Stanislas
Barbeaux, A.
Detroz, Bernard ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Detry, Olivier ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Louis, Edouard ; Université de Liège - ULiège > Département des sciences cliniques > Hépato-gastroentérologie - Relations académiques et scientifiques (Médecine)
Belaiche, Jacques ; Université de Liège - ULiège > Département des sciences cliniques > Hépato-gastroentérologie
Meurisse, Michel ; Université de Liège - ULiège > Département des sciences cliniques > Chirurgicale abdominale
Language :
English
Title :
Development of adenocarcinoma in chronic fistula in Crohn's disease
GILLEN C.D., ANDREWS H.A., PRIOR P., ALLAN R.N. Crohn's disease and colorectal cancer. Gut, 1994, 35 (5): 651-5.
GREENSTEIN A.J., SACHAR D.B., SMITH H., JANOWITZ H.D., AUFSES A.H., Jr. A comparison of cancer risk in Crohn's disease and ulcerative colitis. Cancer, 1981, 48 (12): 2742-5.
GYDE S.N., PRIOR P., MACARTNEY J.C. et al. Malignancy in Crohn's disease. Gut. 1980, 21 (12): 1024-9.
WEEDON D.D., SHORTER R.G., ILSTRUP D.M., HUIZENGA K.A., TAYLOR W.F. Crohn's disease and cancer. N. Engl. J. Med., 1973, 289 (21): 1099-103.
BERNSTEIN C.N., BLANCHARD J.F., KLIEWER E., WAJDA A. Cancer risk in patients with inflammatory bowel disease: a population-based study. Cancer, 2001, 91 (4): 854-62.
EKBOM A., HELMICK C., ZACK M., ADAMI H.O. Increased risk of large-bowel cancer in Crohn's disease with colonic involvement. Lancet, 1990, 336 (8711): 357-9.
BINDER V., HENDRIKSEN C., KREINER S. Prognosis in Crohn's disease - based on results from a regional patient group from the county of Copenhagen. Gut, 1985, 26 (2): 146-50.
GOLLOP J.H., PHILLIPS S.F., MELTON L.J., III, ZINSMEISTER A.R. Epidemiologic aspects of Crohn's disease: a population based study in Olmsted County, Minnesota, 1943-1982. Gut, 1988, 29 (1): 49-56.
KVIST N., JACOBSEN O., NORGAARD P. et al. Malignancy in Crohn's disease. Scand. J. Gastroenterol., 1986, 21 (1): 82-6.
CHAIKHOUNI A., REGUEYRA F.I., STEVENS J.R. Adenocarcinoma in perineal fistulas of Crohn's disease. Dis. Colon Rectum, 1981, 24 (8): 639-43.
CHURCH J.M., WEAKLEY F.L., FAZIO V.W. et al. The relationship between fistulas in Crohn's disease and associated carcinoma. Report of four cases and review of the literature. Dis. Colon Rectum, 1985, 28 (5): 361-6.
COOPER D.J., WEINSTEIN M.A., KORELITZ B.I. Complications of Crohn's disease predisposing to dysplasia and cancer of the intestinal tract: considerations of a surveillance program. J. Clin. Gastroenterol., 1984, 6 (3): 217-24.
LIGHTDALE CJ, STERNBERG SS, POSNER G, SHERLOCK P. Carcinoma complicating Crohn's disease. Report of seven cases and review of the literature. Am. J. Med., 1975, 59 (2): 262-8.
ONERHEIM RM. A case of perianal mucinous adenocarcinoma arising in a fistula-in-ano. A clue to the early pathologic diagnosis. Am. J. Clin. Pathol., 1988, 89 (6): 809-12.
WARREN S SS. Cicatrizing enteritis (regional ileitis) as a pathological entity. Am. J. Pathol., 1948, 24: 475-501.
KY A., SOHN N., WEINSTEIN M.A., KORELITZ B.I. Carcinoma arising in anorectal fistulas of Crohn's disease. Dis. Colon Rectum, 1998, 41 (8): 992-6.
TRAUBE J., SIMPSON S., RIDDELL R.H., LEVIN B., KIRSNER J.B. Crohn's disease and adenocarcinoma of the bowel. Dig. Dis. Sci., 1980, 25 (12): 939-44.
HAMILTON S.R. Colorectal carcinoma in patients with Crohn's disease. Gastroenterology, 1985, 89 (2): 398-407.
PETRAS R.E., MIR-MADJLESSI S.H., FARMER R.G. Crohn's disease and intestinal carcinoma. A report of 11 cases with emphasis on associated epithelial dysplasia. Gastroenterology, 1987, 93 (6): 1307-14.
RICHARDS M.E., RICKERT R.R., NANCE F.C. Crohn's disease-associated carcinoma. A poorly recognized complication of inflammatory bowel disease. Ann. Surg., 1989, 209 (6): 764-73.
STAHL T.J., SCHOETZ D.J. JR., ROBERTS P.L. et al. Crohn's disease and carcinoma: increasing justification for surveillance? Dis. Colon Rectum, 1992, 35 (9): 850-6.
FRESKO D., LAZARUS S.S., DOTAN J., REINGOLD M. Early presentation of carcinoma of the small bowel in Crohn's disease ("Crohn's carcinoma"). Case reports and review of the literature. Gastroenterology, 1982, 82 (4): 783-9.
WARREN R., BARWICK K.W. Crohn's colitis with carcinoma and dysplasia. Report of a case and review of 100 small and large bowel resections for Crohn's disease to detect incidence of dysplasia. Am. J. Surg. Pathol., 1983, 7 (2): 151-9.
