Carcinoma associated with mucosal ulcerative colitis, and with transmural colitis and enteritis (Crohn's disease).

Abstract

Among 1,500 patients with inflammatory disease of the colon and small intestine at the Cleveland Clinic in the past 15 years, 40 have been found to have carcinoma of the colon or small intestine. All records have been reviewed with regard to histologic classification of disease, and clinical correlation. Of these, 37 had carcinoma of the colon accompanying mucosal ulcerative colitis, one had carcinoma and transmural colitis, and two with long-standing transmural (regional) enteritis had carcinoma of the ileum. The factors associated with the development of cancer in ulcerative colitis are: 1. Presence of mucosal disease—very rare in transmural disease; 2. Duration of colitis—average 18 years in this study; 3. Activity of disease—all but one had active, chronic symptoms, and 4. Extent of disease—all but one had total colonic involvement. It is concluded that the mucosal type of ulcerative colitis should be considered potentially malignant.