title: Primary adenocarcinoma in the ileostomy of a woman with familial adenomatous polyposis: a case report and literature review.
abstract: BACKGROUND
  Ileal adenomas associated with familial adenomatous polyposis are a common finding. Many recent studies following panproctocolectomy for familial adenomatous polyposis have confirmed the presence of multiple ileal adenomas and an increase in ileal mucosal proliferation. In this study, we present a case of invasive adenocarcinoma arising in a severely dysplastic tubulovillous adenoma in the ileostomy of a patient with familial adenomatous polyposis; also, we present a literature review. To the best of our knowledge, only very few cases have been reported in the literature.
  
  
  METHODS
  A 59-year-old Caucasian woman developed a primary adenocarcinoma in her ileostomy, complicating the stoma 31 years after its formation.
  
  
  CONCLUSIONS
  Primary adenocarcinoma following panproctocolectomy for familial adenomatous polyposis is a very rare clinical entity. The risk of developing adenocarcinoma in those patients increases with time. Patient education and medical examination of the stoma are of paramount importance and should be implemented early with the need of designing a surveillance protocol for early detection and management of ileal adenomas, especially in longstanding stomas.
authors: Withybush General Hospital, Fishguard Road, Haverfordwest, SA61 2PZ, UK. ahammadfarrag@yahoo.com.
authors: Ahmed
authors: A
authors: Hammad
authors: Raed
authors: R
authors: Tayyem
authors: Peter J
authors: PJ
authors: Milewski
authors: Shanmugavelu
authors: S
authors: Gunasekaran