SQUAMOUS-CELL CARCINOMA COMPLICATING IDIOPATHIC INFLAMMATORY BOWEL-DISEASE

Squamous cell carcinoma of the colon and rectum, originating proximal to the transitional zone, is a rare complication of idiopathic inflamm atory bowel disease (IIBD). To date there are only 15 single case repo rts of such an occurrence. This carcinoma develops more commonly in fe males and in patients with pancolonic disease of more than 8 years' du ration. The rectum is affected in two thirds of the cases. Squamous ce ll changes, in the vicinity of the primary adenocarcinoma, are present in 27% of cases. The carcinoma is in a pathologically advanced stage in one third of the cases. Colectomy is the main therapeutic modality. Survival following surgical resection ranged from 7 months to 21 year s. We present an additional case of rectal squamous cell carcinoma (SC C) complicating chronic ulcerative colitis in a 33-year-old woman who had the disease for 15 years. Multiple biopsies of a gross lesion loca ted 5 cm above the dendate line were consistent with invasive basaloid cell carcinoma. The patient received 5-FU, mitomycin C, and radiother apy prior to a proctocolectomy and ileostomy. The only histopathologic finding at pathologic review of the surgical specimen was severe squa mous dysplasia. (C) 1995 Wiley-Liss, Inc.