Adenocarcinoma in ileal pouch after proctocolectomy for familial adenomatous polyposis: report of a case.
Restorative proctocolectomy with ileal pouch-anal anastomosis is one of the surgical treatments of choice for patients with familial adenomatous polyposis. Although the risk of cancer developing in an ileal pouch is not yet clear, a few cases of adenocarcinoma arising in an ileal pouch have been reported. We report a case of adenocarcinoma in ileal pouch after proctocolectomy with ileal pouch-anal anastomosis. A 56-yr-old woman was diagnosed as having familial adenomatous polyposis. Total colectomy with ileorectal anastomosis was performed. Six years later, she underwent completion-proctectomy with ileal J pouch-anal anastomosis including anorectal mucosectomy for rectal cancer. After 7 yr, she presented with anal spotting. Endoscopic biopsies revealed adenocarcinoma at the ileal pouch. Resection of the ileal pouch and permanent ileostomy were performed. The risk of cancer in an ileal pouch and its prevention with regular surveillance must be emphasized.
Lee
Seung Hyun
SH
Department of Surgery, Kosin University College of Medicine, Busan, Korea.
Ahn
Byung Kwon
BK
Chang
Hee-Kyung
HK
Baek
Sung Uhn
SU
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D011125:Adenomatous Polyposis Coli / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D039021:Colonic Pouches / Q000473:pathology*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D016737:Proctocolectomy, Restorative; D014057:Tomography, X-Ray Computed