Endoscopy lacks sensitivity for detecting small bowel adenocarcinoma (SBA) in patients with Crohn’s disease, researchers from France and the Netherlands report.Reuters Health Information
CONCLUSIONS: Molecular profiling of CD-CRCs and precursor lesions revealed an inflammation-associated landscape of genome alterations: 5p gains and TP53 mutations occurred early in tumor development. Detection of these aberrations in precursor lesions may help predicting disease progression and distinguishes CD-associated from sporadic colorectal neoplasia.
PMID: 29967250 [PubMed – as supplied by publisher]
The development of colorectal cancer in long-standing Crohn’s disease (CD) patients has become a major complication. Therapeutic guidelines for CD-associated cancer (CDAC) have already been established in Western countries; however, specific guidelines are not currently available in Japan. Surveillance of the residual intestine for cancer screening is important for long-standing CD patients. The present case report describes the occurrence of rectal carcinoma in a patient with a 25-year history of CD. A 37-year-old male with a 17-year history of CD underwent semi-emergent subtotal colectomy and ileostomy …
We report the clinical and histologic features of 16 cases (excluding 16 cases of immunoglobulin A vasculitis) diagnosed over a 20-year period. Of the 16 patients, 14 presented with symptoms related to the GI vasculopathy (including 2 presenting with a mass on endoscopic examination). The remaining 2 patients presented with incarcerated hernia and invasive adenocarcinoma. The vasculopathy was not associated with systemic disease and appeared limited to the GI tract in 8 patients. Eight had associated systemic disease, but only 6 had a prior diagnosis. The underlying diagnoses in these 6 patients included systemic lupus ery…
Authors: Matsueda K, Toyokawa T, Sakata M, Fujita I, Horii J
This case report refers to a 31-year-old patient with an 11-year history of Crohn’s disease. The patient presented with an edematous elevated lesion in the splenic flexure. Two histological analyses revealed no signs of obvious dysplasia, and the patient subsequently began infliximab treatment. Nine months later, a worsening of the stricture of the edematous elevated lesion was observed in the splenic flexure, and transverse colonic resection was performed. A histological investigation of the lesion in the splenic flexure revealed advanced adenoc…
ConclusionsThe name ‘primary perianal adenocarcinoma of intestinal type’ is proposed for this previously unrecognised subtype of perineal neoplasia. Awareness of its distinct existence – by recognising its intestinal morphology and immunophenotype while excluding metastasis from the intestinal tract – should help collate data to determine its specific prognosis and to formulate its best management.This article is protected by copyright. All rights reserved.
ConclusionIn this cohort of refractory CD patients receiving long‐term ustekinumab therapy, more than 50% of patients continued ustekinumab treatment with no loss of response, intolerance or surgery and with a good safety profile.
Conclusion: Ileal diverticulosis is not frequent and often asymptomatic as well as adenocarcinoma of the small bowel. In this case, those diseases along with Crohn’s disease led the patient to acute symptoms.
Authors: Hirschmann S, Atreya R, Englbrecht M, Neurath MF
A major challenge in the management of persistently active Crohn’s disease patient’s refractory to treatment regimen following the current guidelines is the induction of remission, which is a prerequisite for subsequent maintenance therapy. The aim of this study was to evaluate both the clinical and endoscopic benefit of intravenous cyclophosphamide pulse therapy in patients with active and therapy refractory Crohn’s disease. Nine patients with acute moderate to severe Crohn’s disease, not responding to conventional as well as biological therapy reg…
We report the first case of retrograde Pagetoid spread from a rectal adenocarcinoma to the vulva and cervix. A 66-year-old woman presented with postmenopausal bleeding and a history of Crohn’s disease. Gynaecological work-up revealed vulvar and endocervical lesions consisting of Paget cells and adenocarcinoma, respectively.