Synchronous adenocarcinoma and carcinoid tumor of the terminal ileum in a Crohn's disease patient

Ugo Cioffi¹ , Matilde De Simone¹ , Stefano Ferrero² , Michele M Ciulla³ , Alessandro Lemos⁴ and Ettore Contessini Avesani¹

¹Department of Surgery, University of Milan, Fondazione Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, IRCCS, Milano, Italy

²Department of Pathology, Azienda Ospedaliera San Paolo, Milano, Italy

³Istituto di Medicina Cardiovascolare, University of Milan, Fondazione Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, IRCCS, Milano, Italy

⁴Department of Radiology, Fondazione Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, IRCCS, Milano, Italy

author email corresponding author email

BMC Cancer 2005, 5:157doi:10.1186/1471-2407-5-157


Published:	8 December 2005

Abstract

Background

Several malignancies have been described in association with inflammatory bowel diseases, the most common being adenocarcinoma. Carcinoid tumor and Crohn disease has also been previously reported, however the coexistence of both neoplasms is quite rare and the clinical diagnosis is very difficult. Here we report what we believe to be the fourth case of a mixed adenocarcinoid tumor coexisting with Crohn's disease.

Case report

The patient presented with clinical and radiological features of intestinal obstruction. Laparotomy showed a stricturing lesion in the last 6 cm of the terminal ileum with proximal dilation. Only the histology of the resected surgical specimen proved the presence of a mixed adenocarcinoid tumor involving the terminal ileum.

Conclusion

Carcinoid tumor should be suspected in elderly patients with Crohn's disease presenting with intestinal obstruction and laparotomy should be considered to exclude malignancy.