Resolving microcarcinoids in ulcerative colitis: report of a case

Area of Science:

• Gastroenterology
• Oncology
• Pathology

Background:

• Ulcerative colitis (UC) is a chronic inflammatory bowel disease associated with an increased risk of colorectal neoplasia, particularly adenocarcinoma.
• Microcarcinoids, small nests of gut endocrine cells in the bowel mucosa/submucosa, are found in chronic inflammation.
• The potential role of microcarcinoids as precursor lesions for carcinoid tumors, despite their rarity in UC patients, remains a concern.

Observation:

• A case report of a 56-year-old male with ulcerative colitis (UC) revealed rectal submucosal microcarcinoids on random biopsies.
• Following successful treatment of his UC, both the inflammation and the microcarcinoids resolved completely.
• Upon six-month follow-up, the patient's UC recurred, accompanied by the reappearance of microcarcinoids.

Findings:

• The observed resolution and recurrence of microcarcinoids correlated directly with the inflammatory status of ulcerative colitis.
• This suggests a potential link between chronic inflammation in UC and the development or manifestation of microcarcinoids.

Implications:

• The findings raise critical questions about the nature of microcarcinoids in the context of UC: are they true neoplastic entities requiring resection, or reactive hyperplastic changes due to inflammation?
• Further research is needed to elucidate the precise biological behavior of microcarcinoids in inflammatory bowel disease.
• Clarifying this distinction is crucial for appropriate patient management and surveillance strategies in ulcerative colitis.
• Understanding this relationship may impact the diagnostic criteria and treatment protocols for patients with both UC and microcarcinoids.