Multifocal small bowel adenocarcinoma with liver metastasis based on a 16-year history of Crohn’s disease

A 49-year-old male patient with a 16-year history of Crohn’s disease had been treated with mesalazine and infliximab. His abdominal pain intensified one year ago, and computed tomography revealed multi-segmental thickening of the small bowel and liver lesions (Fig. 1A & B). Endoscopy found multiple small bowel ulcers (Fig. 2A & B). Endoscopic biopsy and enterectomy specimens confirmed moderately differentiated adenocarcinoma, and liver biopsy confirmed metastatic adenocarcinoma.

Fig. 1

Fig. 2

Although rare, multifocal small bowel adenocarcinoma has significantly increased in frequency among patients with Crohn’s disease, especially those with long disease courses and active stages. When the symptoms of Crohn’s disease worsen, the possibility of malignant transformation should be considered.

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