Abstract
We describe a rare case of right-sided ulcerative colitis (UC) occurring in association with a rectal carcinoid. After resection of the carcinoid tumor, the UC lesions increased in extent.
The patient was a previously healthy 58-year-old male who was referred to our hospital with vomiting and diarrhea. Colonoscopy (CS) revealed a submucosal tumor in the rectum, which was diagnosed as a carcinoid tumor by biopsy. Around the tumor, hyperplasia of the lymphoid follicles was recognized, which was diagnosed as a manifestation of lymphoid follicular proctitis (LFP) .
Repeat CS after two months revealed erosions and disappearance of the vascular patterns in a part of the ascending colon.
Although the histopathological findings in the biopsy specimens at that time were consistent with UC, the patient was managed conservatively, because he was asymptomatic and the site of the lesion was atypical.
As the carcinoid tumor was localized, we resected it endoscopically.
Three months after the endoscopic resection, the UC lesions became aggravated and evidence of LFP could no longer be seen.
The patient began to suffer from loose stools, therefore mesalazine administration was started.
After five months, both the symptoms and the endoscopic findings resolved completely.
In the majority of the reported cases of carcinoid with UC, the carcinoid was present within the range of inflammation, and long-term morbidity cases.
Cases such as the one reported here, in which a carcinoid was present in association with right-sided UC, have not been reported so far.
Further accumulation of similar cases is desired.
