Reddy Vikram B, Aslanian Harold, Suh Namsoo, Longo Walter E
Department of Surgery, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA.
World J Gastroenterol. 2008 Aug 7;14(29):4690-3. doi: 10.3748/wjg.14.4690.
A 53-year old previously healthy male underwent a screening colonoscopy for detection of a potential colorectal neoplasm. The terminal ileum was intubated and a mass was noted. Examination of the colon was normal. The biopsy of the ileal mass was consistent with an adenocarcinoma arising from the terminal ileum. His father who had never been previously ill from gastrointestinal disease died of natural causes, but was found to have Crohn's disease postmortem. The patient underwent exploratory laparotomy and a right hemicolectomy with a 30 cm section of terminal ileum in continuity. Findings were consistent with ileal adenocarcinoma in the setting of Crohn's disease. The patient made an uneventful recovery. The pathology was stage 1 adenocarcinoma. This is a unique case in that on a screening colonoscopy, a favorable ileal adenocarcinoma was discovered in the setting of asymptomatic, undiagnosed ileal Crohn's disease in a patient whose father had Crohn's disease diagnosed postmortem.
一名53岁、此前身体健康的男性接受了结肠镜筛查，以检测潜在的结直肠肿瘤。回肠末端插管检查时发现一个肿物。结肠检查正常。回肠肿物活检结果符合起源于回肠末端的腺癌。他的父亲此前从未患过胃肠道疾病，死于自然原因，但死后尸检发现患有克罗恩病。该患者接受了剖腹探查术及右半结肠切除术，连带切除了30厘米连续的回肠末端。检查结果与克罗恩病背景下的回肠腺癌相符。患者恢复顺利。病理检查为1期腺癌。这是一个独特的病例，即在结肠镜筛查中，一名父亲死后被诊断为克罗恩病的患者，在无症状、未被诊断的回肠克罗恩病背景下发现了预后良好的回肠腺癌。
