Useful endoscopic findings for early diagnosis of ulcerative colitis associated colorectal cancer.

tory bowel disorder associated with a high risk of colorectal cancer [1]. Endo− scopic diagnosis of early ulcerative coli− tis−associated colorectal cancer or pre− cancerous lesions is very difficult [2± 4]. We report three cases with early−stage colorectal cancer or dysplasia examined with conventional endoscopy, magnified endoscopy and/or endoscopic ultraso− nography (EUS). Case 1 (l" Fig. 1) was a 48−year−old wom− an with the total colitis type ulcerative co− litis; the disease duration was 29 years. Through conventional endoscopy, the cancerous lesion was detected as a villous, flat elevation. In the examination using EUS, the cancerous lesion was observed as a hypoechoic area. Because the hypoe− choic area included the cancer itself and concomitant inflammatory cell invasions and fibrosis, the borderline between the neoplastic and non−neoplastic lesion was unclear, making it difficult to evaluate the invasion depth. Histopathologic diag− nosis was well−to−moderately differenti− ated adenocarcinoma and the invasion extended to the muscularis propria.