Eighteen-year surveillance of dysplasia-associated lesion in ulcerative colitis.

The case of a 65 year old patient with ulcerative colitis is reported, who had a dysplasia-associated lesion or mass (DALM) in her rectum. Refusing surgery after detection of the lesion and on follow-up, she underwent surgery only 18 years later when frank carcinoma (Dukes C) was detected. Even if DALM may take a variable course, surgical excision is still highly recommended.