Abstract
A patient 39-year-old male who had 14 years history of ulcerative colitis with recurrent and total colitis type received a surveillance colonoscopy study on the 12th year of the onset of the disease, in which neither cancer nor dysplasia was discovered. On the 13th year of the onset, a barium enema study of the colon was performed which turned out to be negative. However, on the 14th year he was transferred to our hospital with diagnosis of sigmoid colon stenosis causing ileus. Because of the presence of rise of inflammatory signs with defense musculaire, an urgent total colectomy was performed on the same day of admission. Laparotomy revealed an obstructive sigmoid colon cancer with multiple disseminations in the mesenteric peritoneum, stage IV. Pathological study revealed signet cell carcinoma with dysplasia. Barium enema was not diagnostic as a surveillance study and it was thought important to consider the possible presence of highly malignant cancer with rapid progression in case of colitic cancer. We report a case of colitic cancer with rapid progression two years after the negative surveillance colonoscopy. Some review of the relevant literatures were done.
