[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-384240-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-384240-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","synchronous-colon-cancer-presenting-as-toxic-megacolon-in-a-patient-with-ulcerative-colitis-a-case-report","Synchronous colon cancer presenting as toxic megacolon in a patient with ulcerative colitis - A case report","","The report describes a rare presentation of synchronous colorectal cancers in a young woman with established ulcerative colitis (UC) whose initial screening colonoscopy one year earlier showed no dysplasia. She presented with toxic megacolon and acute colonic obstruction, ultimately requiring total abdominal colectomy with end-ileostomy. Postoperative recovery was uneventful and she was referred for adjuvant medical oncology. The authors emphasize that colorectal cancer should remain high on the differential diagnosis in UC patients regardless of age and that oncologic resection principles should guide urgent colectomies.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/synchronous-colon-cancer-presenting-as-toxic-megacolon-in-a-patient-with-ulcerative-colitis-a-case-report/384240/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/synchronous-colon-cancer-presenting-as-toxic-megacolon-in-a-patient-with-ulcerative-colitis-a-case-report/384240.png","ImageObject",300,407,{"name":42,"@type":43},"Kurz","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-27","2026-09-24",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",11,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Why is colorectal cancer risk elevated in ulcerative colitis patients?","Question",{"text":63,"@type":64},"The document explains that colorectal cancer incidence is higher in inflammatory bowel disease, especially ulcerative colitis, with key risk factors including disease duration and extent and with surveillance guided by additional risk markers.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What happened in the presented case of toxic megacolon?",{"text":68,"@type":64},"A 22-year-old woman with UC developed toxic megacolon and acute colonic obstruction despite a normal screening colonoscopy one year prior. She underwent total abdominal colectomy with end-ileostomy, and pathology showed two synchronous colon cancers.",{"name":70,"@type":61,"acceptedAnswer":71},"What are the authors’ main recommendations for clinical practice in ulcerative colitis?",{"text":72,"@type":64},"Colorectal cancer should be considered in the differential diagnosis for UC patients regardless of age, and oncologic principles of colorectal resection should be followed during colonic surgery even in acute settings.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},384240,1790320984,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":97,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145},2336478945635,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","International Journal of Surgery Case Reports 112 (2023) 108984  \nContents lists available at ScienceDirect  \nInternational Journal of Surgery Case Reports  \njournal [homepage:](homepage: www.elsevier.com/locate/ijscr)[ www.elsevier.com/locate/ijscr](homepage: www.elsevier.com/locate/ijscr)  \n| Case report\u003Cbr>Synchronous colon cancer presenting as toxic megacolon in a patient with ulcerative colitis: A case report |  |  | |\n| --- | --- | --- | --- |\n| *\u003Cbr>Emmanuel Luciano , Sarah Macek, Felipe Pacheco, Wael Solh\u003Cbr>Department of Surgery, Central Michigan University College of Medicine, United States of America |  |  |  |\n| A R T I C L E I N F O |  | A B S T R A C T |  |\n| Keywords:\u003Cbr>Case report colon cancer Ulcerative colitis\u003Cbr>Toxic megacolon |  | Introduction and importance: The incidence of colorectal cancer in patients with inflammatory bowel disease is greater than the general population. Of those with inflammatory bowel disease, synchronous cancers are more common in ulcerative colitis than in Crohn's disease. It is rare for synchronous cancer to present as toxic megacolon in a patient with concomitant inflammatory bowel disease, specifically ulcerative colitis.\u003Cbr>Case presentation: In this report, we describe the clinical presentation of a 22-year-old female, who presented with toxic megacolon ultimately requiring total abdominal colectomy with end-ileostomy and a final pathology of two synchronous colon cancers, despite normal colonoscopy one year prior. The postoperative period was unremarkable, and the patient was referred to medical oncology to pursue adjuvant treatment.\u003Cbr>Clinical discussion: Due to the increased incidence of colorectal cancer in patients with ulcerative colitis, screening colonoscopies are typically recommended at more frequent intervals than the general population. Toxic megacolon as the presentation for colon cancer in patients with underlying ulcerative colitis is exceedingly rare. To our knowledge, this is the first case reported of synchronous colon cancer presenting as toxic megacolon in a patient with ulcerative colitis and recent negative screening colonoscopy.\u003Cbr>Conclusion: Colorectal cancer should always be high in the differential diagnosis for patients with ulcerative colitis regardless of the age. The principles of oncologic resection for colorectal cancer should be followed during colonic resections in patients with ulcerative colitis, even in the acute setting. |  |\n\n1. Introduction and importance  \nThere is a well-established association of colorectal cancer (CRC) with inflammatory bowel disease, particularly in ulcerative colitis (UC)  \n[1]. The extent of the risk for CRC in patients with UC varies considerably in the current literature [1]. However, the most important risk factors in UC-associated CRC include duration and extent of disease [1]. Furthermore, synchronous colorectal carcinoma has been reported inpatients with UC [2]. Of these synchronous cancers, the most common sites of occurrence include the proximal colon such as ascending and transverse [2]. With respect to screening for CRC, most societies recommend surveillance ranging from 1 to 5 years based on risk factors including history of dysplasia, family history, active inflammation, and anatomic pathologies such as inflammatory pseudopolyps, or strictures [3]. However, all societies recommend ongoing surveillance colonoscopies for patients with inflammatory bowel disease such as UC or Crohn's disease with involvement of one-third or more of the colon [3].  \nAdditionally, toxic megacolon, which is defined as severe colonic dilation associated with colitis, is associated with inflammatory bowel disease such as UC and Crohn's [5]. However, while colon cancer is a possible etiology of obstruction resulting in toxic megacolon, it is rare and not usually associated with toxic megacolon. We present a case report of a 22-year-old female, with known UC who presented with toxic megacolon in the setting of two synchronou","cbCaiiYHV8djySuk","https://ap.wps.com/l/cbCaiiYHV8djySuk","pdf",1878556,"English","# Introduction and importance\n# Case presentation\n# Clinical discussion\n# Conclusion","[{\"question\":\"Why is colorectal cancer risk elevated in ulcerative colitis patients?\",\"answer\":\"The document explains that colorectal cancer incidence is higher in inflammatory bowel disease, especially ulcerative colitis, with key risk factors including disease duration and extent and with surveillance guided by additional risk markers.\"},{\"question\":\"What happened in the presented case of toxic megacolon?\",\"answer\":\"A 22-year-old woman with UC developed toxic megacolon and acute colonic obstruction despite a normal screening colonoscopy one year prior. She underwent total abdominal colectomy with end-ileostomy, and pathology showed two synchronous colon cancers.\"},{\"question\":\"What are the authors’ main recommendations for clinical practice in ulcerative colitis?\",\"answer\":\"Colorectal cancer should be considered in the differential diagnosis for UC patients regardless of age, and oncologic principles of colorectal resection should be followed during colonic surgery even in acute settings.\"}]","Synchronous colon cancer presenting as toxic megacolon in a patient with ulcerative colitis - A case report | PDF",1790261803,13]