Small bowel adenocarcinoma complicating Crohn's disease: Case series and review of the literature

Lesly A. Dossett, Lisa M. White, Dereck C. Welch, Alan J. Herline, Roberta L. Muldoon, David A. Schwartz, Paul E. Wise

Research output: Contribution to journalReview article

35 Scopus citations

Abstract

Colonic adenocarcinoma frequently complicates inflammatory bowel disease of the colon, but small bowel adenocarcinoma (SBA) is a rare complication of Crohn's disease (CD). We present two patients with SBA in CD and review the literature with regards to CD-related SBA. A 45-year-old male with a 17-year history of ileal CD presented with obstructive symptoms but no radiographic evidence of a mass. After laparoscopic ileocolectomy and repair of incidental ileosigmoid fistula, pathology showed a T3N0 adenocarcinoma within the ileal CD. Two years after his resection he was without evidence of disease. A 59-year-old male with a 15-year history of CD presented with an acute exacerbation. Small bowel follow through demonstrated a long ileal stricture for which he underwent an ileocolic resection. Postoperative pathology confirmed a T3N1 CD-related SBA. He died from metastatic cancer 3 months later. Review of the literature identified 154 cases of SBA complicating CD with several distinguishing features from de novo SBA. Patients with SBA and CD are, as a group, younger and more likely to be male. SBA is rarely diagnosed preoperatively in these patients, and has a poor prognosis due to its advanced stage at diagnosis.

Original languageEnglish (US)
Pages (from-to)1181-1187
Number of pages7
JournalAmerican Surgeon
Volume73
Issue number11
StatePublished - Nov 1 2007

ASJC Scopus subject areas

  • Surgery

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    Dossett, L. A., White, L. M., Welch, D. C., Herline, A. J., Muldoon, R. L., Schwartz, D. A., & Wise, P. E. (2007). Small bowel adenocarcinoma complicating Crohn's disease: Case series and review of the literature. American Surgeon, 73(11), 1181-1187.