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      Solitary Microcarcinoid of the Rectal Stump in Ulcerative Colitis

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          A case of solitary microcarcinoid and chronic ulcerative colitis of the rectal stump is described. The association of intestinal carcinoid with ulcerative colitis has been reported previously in 26 patients. Pathogenic pathways are discussed according to the presence of multifocal carcinoid and/or gut endocrine cell hyperplasia.

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          Most cited references 12

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          Cancer of the rectum following colectomy and ileorectal anastomosis for ulcerative colitis.

          The case notes of all patients treated for ulcerative colitis by colectomy and ileorectal anastomosis at the Gordon Hospital under the care of Mr S. O. Aylett from 1952 to 1976 have been reviewed. Three hundred and seventy-four patients left hospital with an ileorectal anastomosis and have been followed for periods up to 23 years. Twenty-two patients are known to have developed a carcinoma of the rectum. Within 10 years of the onset of the disease, no rectal carcinoma was found in 3534 patient-years. The risk was 1 in 185 patient-years between the tenth and twentieth years and 1 in 115 patient-years between the twentieth and thirtieth years. The cumulative risk was 6 per cent (+/- 2 per cent) at 20 years and 15 per cent (+/- 4 per cent) at 30 years. The need for meticulous follow-up is emphasized. The finding of dysplasia in rectal mucosal biopsies will, it is hoped, identify the patient at particularly high risk and enable rectal excision to be undertaken before carcinoma develops.
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            Total abdominal colectomy and ileorectal anastomosis for inflammatory bowel disease.

             R L Pastore,  B Wolff,  D Hodge (1997)
            This retrospective study assesses the results of total colectomy and ileorectostomy for inflammatory bowel disease.
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              Enteroendocrine cell hyperplasia, carcinoid tumours and adenocarcinoma in long-standing ulcerative colitis.

              Chronic ulcerative colitis may be accompanied by a variety of epithelial changes, including loss of goblet cells, Paneth cell metaplasia, villous metaplasia, and dysplasia. Total colitis is also accompanied by an increased incidence of adenocarcinoma. All these changes are assumed to be secondary to repeated mucosal damage, but how they develop is unknown. Little attention has been paid to the enteroendocrine cell population, despite the postulated role of these cells as producers of trophic hormones. We describe two patients with long-standing ulcerative colitis who developed both adenocarcinoma and carcinoid tumours. In both, there were increased numbers of enteroendocrine cells in the uninvolved colonic mucosa. We suggest that an increased enteroendocrine cell mass may be part of a non-specific reaction to chronic mucosal injury, and by producing an elevated level of trophic hormones may act as a promoter in the development of neoplasia.

                Author and article information

                S. Karger AG
                November 2005
                30 November 2005
                : 81
                : 6
                : 400-404
                aCattedra di Chirurgia Generale, and bCattedra di Anatomia Patologica, Università degli Studi di Brescia, and cSezione di Anatomia Patologica, Dipartimento di Patologia e Medicina di Laboratorio, Università degli Studi di Parma, Parma, Italy
                89558 Neuroendocrinology 2005;81:400–404
                © 2005 S. Karger AG, Basel

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                Page count
                Figures: 1, Tables: 1, References: 21, Pages: 5
                Original Paper


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