Gastric carcinoma in patients with Crohn disease: report of four cases.

Abstract

An association between Crohn disease and gastric carcinoma has not been described before. However, we report four patients with documented Crohn disease in whom gastric carcinoma developed later. In three of the four patients, onset of Crohn disease occurred after the age of 40. All of the patients had nonspecific constitutional symptoms and/or complaints referable to the upper gastrointestinal tract. No clinical evidence of active Crohn disease was present. In each patient, barium examination and CT showed either a mass (two cases) or other radiologic features of malignancy (two cases). Endoscopy with biopsy was performed in three patients and findings were misleading in two patients. The possibility of an increased risk of malignancy in sites remote from inflamed bowel segments has been reported. The findings in this study suggest that patients with Crohn disease, particularly disease of late onset, may be predisposed to the development of gastric carcinoma.