Malignancy Associated with Inflammatory Bowel Disease

[Primary squamous cell carcinoma of the ascending colon: report of a case and Korean literature review]

Primary squamous cell carcinoma of the colon is an extremely rare malignancy. A 48-year-old male visited our hospital for screening colonoscopy. Colonoscopic examination showed a 1 cm sized sessile polyp in the ascending colon. The patient underwent endoscopic mucosal resection (EMR) without any complication. The pathologic findings were compatible with squamous differentiation of tumor cells in inflammatory colonic mucosa. The tumor was confined to the mucosa and the margins of the excised tissue were found to be free of the tumor. There were no other primary sites and no distant metastases in the extensive evaluation using a whole body CT scan and PET-CT. Additional surgical resection was not done. Follow-up colonoscopy performed eight month later showed a whitish scar without evidence of local recurrence and follow-up PET-CT demonstrated no evidence of recurrence. Herein, we report a case of primary squamous cell carcinoma of the ascending colon presenting as a sessile polyp which was removed by EMR.

[A case of squamous cell carcinoma of the breast in a patient with Crohn's disease taking azathioprine]

Azathioprine (AZA) treatment in transplant or autoimmune patients and subsequent appearance squamous cell carcinomas at various sites, particularly skin and cervix, has shown a close relationship. However, it remains uncertain whether this is true for the patients with Crohn's disease. We report a case of squamous cell carcinoma of the breast occurred in a 35-year-old female with Crohn's disease taking AZA. She was first diagnosed with Crohn's disease 10 years ago and has taken AZA with 5-aminosalicylic acid (5-ASA) on regular follow up in gastrointestinal department for 9 years. She had no family history of breast cancer. She visited breast cancer clinic due to incidentally found right breast mass. A mastectomy on the right breast was performed and 6.3×5.5 cm mass was removed. The mass was microscopically proven to be poorly differentiated squamous cell carcinoma with focal keratin pearl formation. At age of 25, she was first diagnosed with active Crohn's disease. 5-ASA and corticosteroid induced remission. Then, steroid was tapered off and AZA was maintained at 1 mg/kg due to leukopenia at higher dose. She stopped taking AZA at her discretion during her two pregnancies and reported total of 67 months of AZA medication on her breast cancer diagnosis.