Adenocarcinoma arising from the rectal stump eleven years after excision of an ileal J-pouch in a patient with ulcerative colitis: report of a case.
Adenocarcinomas in relation to the ileal J-pouch after restorative proctocolectomy for ulcerative colitis have been recently reported with increasing frequency. All previously reported cases have occurred in patients with their ileal pouch in situ. We report a case of adenocarcinoma in the anal canal 11 years after removal of a failed ileal J-pouch. Mucosectomy had been performed at the restorative proctocolectomy. The anus had been left in place at the pouch excision because of severe fibrosis in the pelvis. If it is decided to remove an ileal pouch permanently, a total abdominoperineal excision should be performed, particularly in patients with risk factors for cancer development.
Pedersen
Mark E
ME
Department of Surgery, Odense University Hospital, Odense C, DK-5000, Denmark. markep01@gmail.com
Rahr
Hans B
HB
Fenger
Claus
C
Qvist
Niels
N
D002288:Adenocarcinoma, Mucinous / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D000714:Anastomosis, Surgical; D001706:Biopsy; D003093:Colitis, Ulcerative / Q000601:surgery*; D039021:Colonic Pouches / Q000473:pathology*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005500:Follow-Up Studies; D006801:Humans; D007081:Ileostomy; D008297:Male; D008875:Middle Aged; D016737:Proctocolectomy, Restorative / Q000379:methods; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D013997:Time Factors; D014057:Tomography, X-Ray Computed