Pathologic features of colorectal carcinomas associated with Crohn's disease in Korean population.

BACKGROUND: Colorectal cancer (CRC) has been known to complicate Crohn's disease (CD). Several reports in Western population revealed that CRC in CD were characterized by much younger onset and equal distribution of tumors along the entire colon. However, clinicopathologic features of CD-associated CRC in Korean population have not been well documented yet.

METHODS: Among 2968 Korean CD patients, 16 patients (0.54%) were found to develop CRC during follow up. We reviewed clinicopathologic features of the 16 CRC patients.

RESULTS: The mean age at the time of CRC diagnosis was 39.3 years (range 18-59 years) and 14 of the 16 CRCs (87.5%) occurred in anorectal region. Mucinous adenocarcinoma was strikingly frequent (9/16, 56.3%) and eight cases (8/9) of the mucinous adenocarcinoma cases were located at anorectal area. The other cases consisted of 4 tubular adenocarcinomas, 2 signet ring cell carcinomas and 1 neuroendocrine tumor. Thirteen patients (81.3%) had a history of perianal fistula and 8 of them had a histological association between the CRC and the perianal fistula.

CONCLUSIONS: CD-associated CRC was characterized by young age at diagnosis, mucinous histology and association with perianal fistula in Korean patients.