A patient with a history of malignant degeneration in an area of regional enteritis required a right colectomy for partial obstruction and exacerbation of infection ten years after the onset of regional ileitis, which was treated medically in the interim. Carcinoma of the ileum was found and the involved segment was studied pathologically. The patient developed metastases and died one year later.
Twenty-six cases of carcinoma in regional ileitis have been reported in the literature since 1956. Five-year survivals of 3.7% and an average survival of 6.56 months reveal an extremely poor prognosis. Only 14% of the conditions were diagnosed preoperatively or intraoperatively. More than 80% of the diagnoses were made postoperatively or at autopsy. It is concluded that any rapid deterioration or anemia in a patient with satisfactory, controlled regional enteritis should arouse suspicion of a malignant neoplasm.