F. Pfeffel et al., Coincidence of Crohn's disease and a high-risk gastrointestinal stromal tumor of the terminal ileum, DIGESTION, 60(4), 1999, pp. 363-366
A 51-year-old male patient presented with characteristic radiologic feature
s of Crohn's disease in the terminal ileum plus a large tumorous lesion in
the right lower abdomen. Because of rapid crescent symptoms of bowel obstru
ction, the patient underwent surgery revealing a high-risk gastrointestinal
stromal tumor (GIST) of the terminal ileum within an area of Crohn's ileit
is. Whereas the association of chronic inflammatory bowel disease (IBD) and
gastrointestinal adenocarcinoma is well known, other primary intestinal tu
mors are rare in these patients, particularly at the time of onset of clini
cal symptoms. This is the 3rd patient reported in the literature with a sar
coma complicating IBD, and in fact, the first description of the coincidenc
e of Crohn's disease and GIST. Though the present case is likely to be a me
re coincidence of two pathologically distinct entities (without any potenti
al causal relationship), it should remind one of the possibility of small b
owel 'Crohn's carcinoma' in patients with a sudden change in symptomatology
as well as in those in whom intestinal obstruction fails to resolve with a
dequate therapy.