Abstract
The first case was a 58-year-old male suffering from total colitis for 18 years. A IIa+ IIc type lesion was disclosed in the rectum by a barium enema study when diarrhea worsened. Based on a diagnosis of early rectal cancer, peranal transection of the tumor was performed. Only 4 months later, 4 lesions of cancer inclusive of Borrmann I type tumor infiltrating to the serosa were found around the rectal incision. The second case was a 72-year-old female with a history of left-sided colitis for 11 years. Colonoscopy was performed annually for 8 years, and a red flat elavated lesion was revealed in the rectum. Left side colectomy was performed under a diagnosis of early rectal cancer. Histologically these flat elevated lesions were well differentiated adenocarcinoma and mucosal carcinoma surrounded with dysplasia. Therefore, these lesions were thought to be developed from ulcerative colitis. Patients with a history of more than 10 years of ulcerative colitis should undergo surveillance colonoscopy annually. Careful observation focusing on elevated lesions in the rectum and biopsies should be performed at each examination.
