Letters To The Editor
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Dec 14, 2009; 15(46): 5882-5883
Published online Dec 14, 2009. doi: 10.3748/wjg.15.5882
Lethal neuroendocrine carcinoma in ulcerative colitis
Hugh J Freeman, Ken Berean
Hugh J Freeman, Department of Medicine (Gastroenterology), University of British Columbia, Vancouver, BC, V6T 1W5, Canada
Ken Berean, Department of Pathology, University of British Columbia, Vancouver, BC, V6T 1W5, Canada
Author contributions: Freeman HJ and Berean K contributed equally to this work.
Correspondence to: Hugh J Freeman, MD, Professor, Department of Medicine (Gastroenterology), UBC Hospital, 2211 Wesbrook Mall, Vancouver, BC, V6T 1W5, Canada. hugfree@shaw.ca
Telephone: +1-604-8227216 Fax: +1-604-8227236
Received: October 19, 2009
Revised: November 7, 2009
Accepted: November 14, 2009
Published online: December 14, 2009
Abstract

A 48-year old male with longstanding and extensive pancolitis developed a high grade and rapidly lethal malignant lesion in the ascending colon characterized by a neuroendocrine carcinoma. Prior biopsies obtained from multiple sites in the colon during endoscopic surveillance were reported to show only inflammatory changes without dysplasia. Although operator-dependent, repeated endoscopic studies may have limitations during surveillance programs because the biological behavior of some colonic neoplastic lesions may have a rapid and very aggressive clinical course.

Keywords: Colorectal cancer, Neuroendocrine carcinoma, Ulcerative colitis, Surveillance colonoscopy, Dysplasia