Colon nontumor
Inflammatory bowel disease (IBD)
Ulcerative colitis associated carcinoma

Topic Completed: 1 May 2013

Revised: 8 January 2019, last major update May 2013

Copyright: (c) 2003-2016,, Inc.

PubMed Search: Ulcerative colitis associated carcinoma [title]

Related topics: Intestinal low-grade tubuloglandular adenocarcinoma, Carcinoma in pouches

Hanni Gulwani, M.B.B.S.
Page views in 2019: 524
Page views in 2020 to date: 39
Cite this page: Gulwani H. Ulcerative colitis associated carcinoma. website. Accessed January 24th, 2020.
Definition / general
  • Regular colonoscopy with biopsy recommended in patients with long-standing extensive colitis to detect precancerous dysplastic changes
  • Overall risk of carcinoma is 3 - 5% at 20 years, 8% at 30 years and 11% at 40 years (Gastroenterology 2006;130:1030, Inflamm Bowel Dis 2006;12:205)
  • 10 - 20% have multiple tumors (more common in younger individuals)
  • Usually arises from flat mucosa
  • Tumors more often are poorly differentiated or mucinous carcinomas, also neuroendocrine neoplasms
  • Tumors more often are inoperable or high stage
Prognostic factors
  • Poor prognosis overall (Diagn Pathol 2011;6:30)
  • Adverse prognostic factors for development of carcinoma in ulcerative colitis: onset in children (43% risk after 35 years), duration greater than 10 years, involvement of entire length of colon, high grade dysplastic changes, dysplasia-associated lesions and masses (DALM), pericholangitis, primary sclerosing cholangitis (Gastrointest Endosc 2002;56:48), history of pseudopolyps, family history (Br J Surg 2005;92:928)
  • Favorable prognostic factors: 1 or 2 surveillance colonoscopies, smoking, use of corticosteroids, aspirin or NSAIDs (Gastroenterology 2006;130:1941)
Case reports
Gross description
  • Carcinomas: early - thickened mucosa with finely nodular or velvety surface
Gross images

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Ulcerative colitis and small cell carcinoma

Microscopic (histologic) images

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UC and small cell carcinoma (this and next row)





Various immunostains

CD44, Zo1 and occludin


Positive stains
Differential diagnosis
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