Chaikhouni A, Regueyra F I, Stevens J R
Dis Colon Rectum. 1981 Nov-Dec;24(8):639-43. doi: 10.1007/BF02605765.
Until recently, Crohn's disease has not been regarded as a premalignant lesion, but the increasing number of patients with Crohn's disease in whom adenocarcinoma of the gastrointestinal tract develops strongly suggests that these patients are indeed at a higher risk for carcinoma. These patients are usually young and tend to develop a malignancy in the bypassed ileum or right colon. Patients with such lesions usually have a poor prognosis. Adenocarcinoma arising in perineal fistulas secondary to Crohn's disease has not been reported in English medical literature except for one case published in 1975. In this article, the authors report a second, similar case of Crohn's disease with recurrent perineal fistulas. An infiltrating adenocarcinoma developed in these fistulas, in the anorectal region, and in the left labia. The risk of malignancy should be seriously considered in the management of Crohn's disease, especially in young patients. Because of the risk of adenocarcinoma in these patients, resection rather than bypass is recommended in the surgical management.
直到最近，克罗恩病都未被视为一种癌前病变，但胃肠道腺癌在克罗恩病患者中日益增多，这有力地表明这些患者患癌风险确实更高。这些患者通常较为年轻，且倾向于在旷置的回肠或右半结肠发生恶性肿瘤。患有此类病变的患者预后通常较差。除1975年发表的1例病例外，英文医学文献中尚未报道过克罗恩病继发会阴瘘引发的腺癌。在本文中，作者报告了第二例类似的、伴有复发性会阴瘘的克罗恩病病例。这些瘘管、肛门直肠区域及左侧阴唇均发生了浸润性腺癌。在克罗恩病的治疗中，尤其是年轻患者，应认真考虑恶性肿瘤的风险。鉴于这些患者存在腺癌风险，手术治疗时建议行切除术而非旁路手术。
