Laparoscopic resection of a tumor in the descending colon cancer associated with Crohn's disease: a case report

Background: Although patients with Crohn’s disease are at an increased risk of cancer, surveillance strategies and surgical guidelines for colorectal cancer that is associated with Crohn’s disease have not been established. Case report: We describe a 60-year-old man with a 30-year history of Crohn’s disease within the large bowel who had been undergoing annual colonoscopic surveillance and presented with a tumor in the descending colon. An elevated mass lesion that occupied the intestinal lumen was not detected until one year after his last surveillance procedure. A biopsy of the lesion revealed high-grade dysplasia, and immunohistochemistry showed that the lesion was positive for tumor protein p53. We suspected cancer in the descending colon as a complication of Crohn’s disease and performed a laparoscopic-assisted left hemicolectomy. Histologically, this patient had stage II colon cancer. Conclusion: An accumulation of case reports that describe Crohn’s disease in association with cancer will help to establish suitable surveillance strategies and surgical procedures. Therefore, the need for surveillance to manage patients with Crohn’s disease must be discussed in the future.