| Theme |
Colorectal cancer in ulcerative colitis |
| Title |
Possible roles of endoscopic ultrasonography in ulcerative colitis associated colorectal cancer |
| Author |
Seiji Shimizu |
Department of Gastroenterology, JR West Osaka General Hospital |
| Author |
Hideo Tomioka |
Department of Gastroenterology, JR West Osaka General Hospital |
| Author |
Motoki Watanabe |
Department of Gastroenterology, JR West Osaka General Hospital |
| Author |
Masahiro Tada |
Tada Gastroenterological Clinic |
| [ Summary ] |
The possible roles for endoscopic ultrasonography (EUS) in the diagnosis of ulcerative colitis associated colorectal cancer were described, based on our experience with six cancers out of five cases. The existence of cancer could be seen with EUS in invasive cancer cases. However, mucosal cancers and dysplasias could not be distinguished from inflammatory prominences. In one case, the existence of an invasive cancer was noticed by using EUS, preceding endoscopic detection and histological confirmation. The qualitative diagnosis of cancer was possible for invasive cancers, based on the presence of hypoechoic areas with irregular contours penetrating the wall layers. The presence of mucinous components was suspected in the areas with lower echo levels. The depth of cancer infiltration could be estimated by use of EUS when instruments were properly chosen. EUS was also useful to exclude the presence of invasive cancers when strictures or prominences were observed. Although the number of proven cases was small, EUS may have the potential to detect invasive cancers and may be useful if incorporated into cancer surveillance for long standing ulcerative colitis. |