Cancer of the Descending Colon Associated with Ulcerative Colitis, Report of a Case Masahiro Tanaka 1 , Hiroyoshi Arai 1 , Ken Kirnura 1 , Ken Saito 2 1Department of Gastroenterology, Jichi Medical School, School of Medicine 2Department of Pathology, Jichi Medical School, School of Medicine pp.957-960
Published Date 1986/9/25
DOI https://doi.org/10.11477/mf.1403110211
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 A 35 year-old man with frequent mucobloody stool over a period of seventeen years was admitted to Jichi Medical School Hospital. Severe anemia, periproctal abscess and weakness of sight were noted. Barium enema revealed lack of haustration in the entire colon, polypoid lesion in the descending colon, and tubular narrowing in the descendicosigmoid junction. Endoscopic examination from transverse colostomy showed polypoid lesion of descending colon. The lesion had the cobblestone pattern appearance characteristic of Crohn's disease. Biopsy specimen under direct vision showed marked inflammation with epithelial atypia in the “cobblestony” lesion, and atrophic mucosa without atypia at the descendicosigmoid junction. Resected specimen revealed the atrophic flat mucosa with multiple erosions in the colon on the left side, narrowed segment with exposure of proper muscle coat at the descendicosigmoid junction and advanced cancer (6. 0 X 2. 5 cm) invading the subserosa in the upper part of the descending colon. Histological findings disclosed moderately differentiated adenocarcinoma with marked venous and lymphatic invasion, and various degrees of epithelial dysplasia in the mucosa of the ascending colon and the narrowed portion. Two years and nine months after surgery, the patient died of cancer recurrence, such as liver metastasis and intestinal obstruction.

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