Precise endoscopic and pathologic features in a crohn's disease case with two fistula-associated small bowel adenocarcinomas complicated by an anal canal adenocarcinoma

Abstract

The patient was a 40-year-old man who had suffered from Crohn's disease (CD) for 19 years and devel-oped an intractable perianal fistula and two strictures in the small bowel. Dilatation of the two strictures us-ing double-balloon endoscopy did not improve the subileus symptoms. An anal canal adenocarcinoma was also detected using double-balloon endoscopy. The ileum and rectoperianal area were partially resected, and a precise immunohistochemical pathologic assessment revealed that all three lesions were fistula-associated adenocarcinomas. Accumulating endoscopic findings of CD-associated cancer and precise pathologic diagnos-tic findings will help to establish a suitable surveillance method. © 2013 The Japanese Society of Internal Medicine.