title: Adenocarcinoma of the anal transitional zone after double stapled ileal pouch-anal anastomosis for ulcerative colitis.
abstract: The development of adenocarcinoma in the anal transitional zone, after restorative proctocolectomy for ulcerative colitis, is rare. We report the first Asian and sixth known case. A 41-year-old Indian lady had a long standing history of ulcerative colitis. Restorative proctocolectomy and stapled ileal pouch-anal anastomosis without mucosectomy was performed. She remained asymptomatic until 3 years later when she complained of discomfort on defecation. A poorly differentiated adenocarcinoma in the anal transition zone was diagnosed and she subsequently underwent an abdomino-perineal resection. The previously reported cases in the literature are reviewed. We also discuss the suggested surveillance for high-risk patients who have undergone an ileal-anal pouch anastomosis.
authors.affiliation: Department of Colorectal Surgery, Singapore General Hospital, Singapore.
authors.forename: C S
authors.initials: CS
authors.lastname: Chia
authors.forename: M H
authors.initials: MH
authors.lastname: Chew
authors.forename: Y P
authors.initials: YP
authors.lastname: Chau
authors.forename: K W
authors.initials: KW
authors.lastname: Eu
authors.forename: K S
authors.initials: KS
authors.lastname: Ho
mesh_terms: D000230:Adenocarcinoma / Q000209:etiology* / Q000601:surgery; D000328:Adult; D001003:Anal Canal / Q000601:surgery*; D000714:Anastomosis, Surgical; D001005:Anus Neoplasms / Q000209:etiology* / Q000601:surgery; D003093:Colitis, Ulcerative / Q000601:surgery*; D039021:Colonic Pouches; D005260:Female; D006801:Humans; D016737:Proctocolectomy, Restorative; D012086:Reoperation; D017792:Surgical Stapling