Synchronous colorectal neoplasms in ulcerative pancolitis of 6 years duration

Pathological and molecular heterogeneity

B. M. Shivakumar, Lakshmi Rao, K. Satyamoorthy, Ganesh C. Pai

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Colorectal cancer (CRC) complicating ulcerative colitis (UC) accounts for about 1% of all cases of CRC. Such tumours develop from pre-existing foci of dysplasia in patients with extensive and long-standing UC. We report a case of UC-associated synchronous CRC and foci of high-grade dysplasia with an additional malignant focus in the appendix in a female patient after only 6 years of pancolitis who did not have other risk factors for the development of complications. The multiplicity and the timings of the early changes noted suggest that longstanding inflammation in UC randomly damages multiple genes in epithelial cells known to contribute to colorectal carcinogenesis. Current findings also support a molecular and pathological heterogeneity during multiclonal origin of synchronous tumours whereby differences occur at various sites that were absent during the initial stages of the disease.

Original languageEnglish
Article number200172
JournalBMJ Case Reports
DOIs
Publication statusPublished - 02-07-2013

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Multiple Primary Neoplasms
Ulcerative Colitis
Colorectal Neoplasms
Neoplasms
Carcinogenesis
Epithelial Cells
Inflammation
Genes

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

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title = "Synchronous colorectal neoplasms in ulcerative pancolitis of 6 years duration: Pathological and molecular heterogeneity",
abstract = "Colorectal cancer (CRC) complicating ulcerative colitis (UC) accounts for about 1{\%} of all cases of CRC. Such tumours develop from pre-existing foci of dysplasia in patients with extensive and long-standing UC. We report a case of UC-associated synchronous CRC and foci of high-grade dysplasia with an additional malignant focus in the appendix in a female patient after only 6 years of pancolitis who did not have other risk factors for the development of complications. The multiplicity and the timings of the early changes noted suggest that longstanding inflammation in UC randomly damages multiple genes in epithelial cells known to contribute to colorectal carcinogenesis. Current findings also support a molecular and pathological heterogeneity during multiclonal origin of synchronous tumours whereby differences occur at various sites that were absent during the initial stages of the disease.",
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AU - Pai, Ganesh C.

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AB - Colorectal cancer (CRC) complicating ulcerative colitis (UC) accounts for about 1% of all cases of CRC. Such tumours develop from pre-existing foci of dysplasia in patients with extensive and long-standing UC. We report a case of UC-associated synchronous CRC and foci of high-grade dysplasia with an additional malignant focus in the appendix in a female patient after only 6 years of pancolitis who did not have other risk factors for the development of complications. The multiplicity and the timings of the early changes noted suggest that longstanding inflammation in UC randomly damages multiple genes in epithelial cells known to contribute to colorectal carcinogenesis. Current findings also support a molecular and pathological heterogeneity during multiclonal origin of synchronous tumours whereby differences occur at various sites that were absent during the initial stages of the disease.

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