Carcinoma of the Colon in Chronic Ulcerative Colitis
RUPERT B. TURNBULL, M.D.
Department of Surgery
CHARLES H. BROWN, M.D.
Department of Gastroenterology
IT is generally understood that carcinomas of the colon arising in the course of ulcerative colitis are highly malignant and invasive,1,2 metastasize early, and have a short survival period following resection. The following 2 cases are reported because the patients are alive and well, without evidence of recurrent neoplasm for 5 years.
Case 1. A 56 year old white man was seen for the first time at the Clinic on January 21, 1948. He had suffered from a mild chronic ulcerative colitis involving the entire colon and rectum for a period of 10 years. Frequent roentgenograms were taken of the colon and proctoscopic examinations were made during this interval. At no time had his symptoms been severe enough to warrant surgical intervention. During the preceding year he had noted frequent bleeding from the rectum, after which he submitted to examinations at closer intervals. Six months prior to admission to the hospital, several ulcerating lesions were found in the rectum. Repeated biopsies revealed adenocarcinoma. The patient was admitted to the hospital on February 10, 1948, at which time abdominoperineal resection was performed. His convalescence was uneventful.
Pathology: The open rectum and sigmoid colon revealed considerable thickening of the walls with loss of the usual mucosal folds. The mucosa was finely granular and manifested all the characteristics of chronic ulcerative colitis. Eight cm. above the dentate line the mucosal surface presented 5 rounded elevations with finely granular surfaces, the largest of which was 1.5 cm. in diameter and raised above. . .