Problems in Cancer Surveillance in Ulcerative Colitis Tadashi Yokoyama 1 , Osamu Ito 2,3 , Yasuhisa Yokoyama 1 1Department of Surgery, Yokoyama Hospital for Gastrointestinal Diseases 2Department of Gastroenterology, Miyoshi Municipal Hospital Keyword: 潰瘍性大腸炎 , 大腸癌 , dysplasia , サーベイランス , 拡大内視鏡 pp.915-923
Published Date 2002/6/25
DOI https://doi.org/10.11477/mf.1403104488
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 We report here two patients with rectal cancer associated with ulcerative colitis. Both cases showed some problems in cancer surveillance. Case 1 was a 40-year-old male with left-sided colitis for 12 years' duration. The result of previous surveillance was negative, but rectal cancer involving the serosal surface was found after an interval of two years and three months. Problems of pathological interpretation of the biopsy specimen and the surveillance interval were discussed. Case 2 was a 42-year-old male with left-sided colitis for 8 years' duration. He had persistent symptoms and was referred to our hospital. The first colonoscopy revealed an adenoma-like tumor 3.8 cm × 3.0 cm in his rectum. Total colectomy was carried out and the tumor was, pathologically, adenocarcinoma in an adenoma, suggestive of coincidental tumor not closely associated with colitis. The relatively short duration of his colitis and the evidence of left-sided colitis were compatible with these pathological findings. New endoscopic (magnifying colonoscopy ?) and histopathologic techniques should be developed to improve the identification of the dysplastic lesion which, so far, is not easily visible with routine examination.

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