Yokota Yumi, Anzai Hiroyuki, Nagai Yuzo, Sonoda Hirofumi, Shinagawa Takahide, Yoshioka Yuichiro, Abe Shinya, Yokoyama Yuichiro, Matsuzaki Hiroyuki, Emoto Shigenobu, Murono Koji, Sasaki Kazuhito, Nozawa Hiroaki, Ushiku Tetsuo, Ishihara Soichiro
Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
Division of Pathology, Department of Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
Ann Coloproctol. 2024 May;40(Suppl 1):S32-S37. doi: 10.3393/ac.2022.00801.0114. Epub 2023 Apr 19.
Adenocarcinoma is a common histological type of ulcerative colitis-associated cancer (UCAC), whereas neuroendocrine carcinoma (NEC) is extremely rare. UCAC is generally diagnosed at an advanced stage, even with regular surveillance colonoscopy. A 41-year-old man with a 17-year history of UC began receiving surveillance colonoscopy at the age of 37 years; 2 years later, dysplasia was detected in the sigmoid colon, and he underwent colonoscopy every 3 to 6 months. Approximately 1.5 years thereafter, a flat adenocarcinoma lesion occurred in the rectum. Flat lesions with high-grade dysplasia were found in the sigmoid colon and surrounding area. The patient underwent laparoscopic total proctocolectomy and ileal pouch-anal anastomosis with ileostomy. Adenocarcinoma was diagnosed in the sigmoid colon and NEC in the rectum. One year postoperation, recurrence or metastasis was not evident. Regular surveillance colonoscopy is important in patients with long-term UC. A histological examination of UCAC might demonstrate NEC.
腺癌是溃疡性结肠炎相关癌（UCAC）常见的组织学类型，而神经内分泌癌（NEC）极为罕见。即使进行定期监测结肠镜检查，UCAC通常也在晚期才被诊断出来。一名有17年溃疡性结肠炎病史的41岁男性在37岁时开始接受监测结肠镜检查；2年后，在乙状结肠发现发育异常，此后他每3至6个月接受一次结肠镜检查。大约1.5年后，直肠出现一个扁平腺癌病灶。在乙状结肠及其周围区域发现了伴有高级别发育异常的扁平病灶。该患者接受了腹腔镜全直肠结肠切除术及回肠贮袋肛管吻合术并保留回肠造口。乙状结肠诊断为腺癌，直肠诊断为NEC。术后一年，未见复发或转移。对于长期患溃疡性结肠炎的患者，定期监测结肠镜检查很重要。UCAC的组织学检查可能显示为NEC。
