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Small bowel cancer in a patient with Crohn’s disease diagnosed preoperatively by double-balloon enteroscopy

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Abstract

A 53-year-old female patient, who had been treated for Crohn’s disease for approximately 20 years, was admitted to our hospital with a chief complaint of persistent bloody stools. Colonoscopy, computed tomography, and magnetic resonance enterography revealed two stenoses of the ileum and multiple enlarged lymph nodes around the oral-side ileal stenosis. We accordingly performed transoral double-balloon enteroscopy and found ileal stenosis with an irregular mucosal surface. Based on pathological examination of the stenosis, adenocarcinoma of the small bowel was diagnosed for the oral-side stenosis. The stenosis on the anal side was benign. The two stenoses were resected simultaneously, and lymph node dissection was performed on the cancerous lesion. The diagnosis of the cancerous lesion was pStage IIIB, and immunohistochemical staining was positive for tumor protein 53. Patients with Crohn’s disease are at a high risk of small bowel cancer, but no surveillance protocol has been established to date. We encountered a case of Crohn’s disease in which radical surgery was possible, owing to preoperative pathological diagnosis, by using balloon-assisted enteroscopy. In this paper, we report a case that suggests the importance of performing balloon-assisted enteroscopy when small bowel stenosis is detected in patients with Crohn’s disease.

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Abbreviations

SBC:

Small bowel cancer

CD:

Crohn’s disease

5-ASA:

5-Aminosalicylic acid

DBE:

Double-balloon enteroscopy

CS:

Colonoscopy

CT:

Computed tomography

MRE:

Magnetic resonance enterography

IBD:

Inflammatory bowel diseases

TP:

Tumor protein

BAE:

Balloon-assisted enteroscopy

CE:

Capsule endoscopy

References

  1. Canavan C, Abrams KR, Mayberry J. Metaanalysis: colorectal and small bowel cancer risk in patients with Crohn’s disease. Aliment Pharmacol Ther. 2006;23:1097–104.

    Article  CAS  PubMed  Google Scholar 

  2. Ginzburg L, Schneider KM, Dreizin DH, et al. Carcinoma of the jejunum occurring in a case of regional enteritis. Surgery. 1956;39:347–51.

    CAS  PubMed  Google Scholar 

  3. Solem CA, Harmsen WS, Zinsmeister AR, et al. Small intestinal adenocarcinoma in Crohn’s disease. A case-control study. Inflam Bowel Dis. 2004;10:32–5.

    Article  Google Scholar 

  4. Fujita M, Matsubara N, Matsuda I, et al. Genomic landscape of colitis-associated cancer indicates the impact of chronic inflammation and its stratification by mutations in the Wnt signaling. Oncotarget. 2018;9:969–81.

    Article  PubMed  Google Scholar 

  5. Koga H, Aoyagi K, Hizawa K, et al. Rapidly and infiltratively growing Crohn’s carcinoma of the small bowel: serial radiologic findings and a review of the literature. Clin Imaging. 1999;23:298–301.

    Article  CAS  PubMed  Google Scholar 

  6. Katoh H, Ishikawa S. Lifestyles, genetics, and future perspectives on gastric cancer in east Asian populations. J Hum Genet. 2021;66:887–99.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Haselkorn T, Whittemore AS, Lilienfeld DE. Incidence of small bowel cancer in the United States and worldwide: geographic, temporal, and racial differences. Cancer Causes Control. 2005;16:781–7.

    Article  PubMed  Google Scholar 

  8. Obara N, Koganei K, Tatsumi K, et al. A case of Crohn’s disease complicated with simultaneous double cancers of the small bowel. J Jpn Soc Gastroenterol. 2016;113:1901–8 (In Japanese).

    Google Scholar 

  9. Nakao E, Tatsumi K, Kuroki H, et al. Preoperative diagnosis of small intestinal cancer associated with Crohn’s disease: a case report. J Jpn Soc Gastroenterol. 2021;118:645–51 (In Japanese).

    Google Scholar 

  10. Elriz K, Carrat F, Cabonnel F, et al. Incidence, presentation, and prognosis of small bowel adenocarcinoma in patients with small bowel Crohn’s disease:a prospective observational study. Inflam Bowel Dis. 2013;19:1823–6.

    Google Scholar 

  11. Thompson EM, Clayden G, Price AB. Cancer in Crohn’s disease an ‘occult’ malignancy. Histopathology. 1893;7:365–76.

    Article  Google Scholar 

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

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None.

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Authors and Affiliations

  1. Division of Gastroenterology, Tohoku University Graduates School of Medicine, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan

    Kai Korekawa, Takeo Naito, Hiroshi Nagai, Yusuke Shimoyama, Rintaro Moroi, Hisashi Shiga, Yoichi Kakuta & Atsushi Masamune

  2. Department of Pathology, Tohoku University Graduates School of Medicine, Miyagi, Japan

    Fumiyoshi Fujishima

Authors
  1. Kai Korekawa
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  2. Takeo Naito
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  3. Fumiyoshi Fujishima
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  4. Hiroshi Nagai
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  5. Yusuke Shimoyama
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  6. Rintaro Moroi
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  7. Hisashi Shiga
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  8. Yoichi Kakuta
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  9. Atsushi Masamune
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Contributions

FF, YS, RM, HS, YK, and AM substantially contributed to manuscript drafting and study conceptualization. All authors critically reviewed and revised the manuscript draft and approved the final version for submission.

Corresponding author

Correspondence to Takeo Naito.

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Authors declare no conflict of interests for this article.

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This study was conducted according to the principles of the Declaration of Helsinki.

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Oral informed consent was obtained from the patient for publication of this case report.

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Korekawa, K., Naito, T., Fujishima, F. et al. Small bowel cancer in a patient with Crohn’s disease diagnosed preoperatively by double-balloon enteroscopy. Clin J Gastroenterol 16, 836–841 (2023). https://doi.org/10.1007/s12328-023-01846-2

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  • DOI: https://doi.org/10.1007/s12328-023-01846-2

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