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Genomic analysis of a case of multifocal adenocarcinoma in ulcerative colitis


Long-standing ulcerative colitis is associated with an elevated risk of developing colonic adenocarcinoma. A very limited group of patients present with multiple synchronous cancers. This could be due to either a multifocal presentation of the same neoplastic clone or different tumors arising in a large area of polyclonal dysplastic colonic mucosa (“field cancerization”). Here, we describe a patient with long-standing colitis and three different tumors in the rectosigmoid part of the large bowel. Clonal evaluation of the lesions was performed by array-based comparative genomic hybridization. These three neoplasms showed a comparable pattern of genomic alterations characterized by gains of chromosomes 12, 13, and 20. Noteworthy, dysplastic mucosa distal to the three cancers displayed a completely different pattern of genomic changes indicating that different cell lineages were present. In addition, all three carcinomas were microsatellite stable and revealed identical immunoprofiles for several cancer-associated genes. We conclude that these three multifocal tumors must have originated from the same preneoplastic lineage.

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Correspondence to Herman van Dekken.

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van Dekken, H., Wink, J.C., Vissers, K.J. et al. Genomic analysis of a case of multifocal adenocarcinoma in ulcerative colitis. Virchows Arch 449, 716–721 (2006). https://doi.org/10.1007/s00428-006-0312-4

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  • Ulcerative colitis
  • Dysplasia
  • Adenocarcinoma
  • Clonal analysis
  • CGH