title: Transverse colon cancer occurring at a colostomy site 35 years after colostomy: a case report.
abstract: BACKGROUND
  Carcinomas occurring at colostomy sites are rare, and most of these are metachronous colorectal cancers. The median time between colostomy and development of a carcinoma at a colostomy site is 22 years, which exceeds the length of the recommended follow-up period. We report a rare case of a carcinoma of the transverse colon occurring at a colostomy site in a patient without a history of colorectal cancer.
  
  
  METHODS
  An 89-year-old woman presented with a tumor occurring at a colostomy site. Thirty-five years previously, she had undergone a transverse loop colostomy for an iatrogenic colon perforation that occurred during left ureteral lithotomy. Upon physical examination, the patient had a hard nodule measuring 3 cm at the colostomy site. A biopsy of the nodule suggested adenocarcinoma, and the preoperative diagnosis was transverse colon cancer. A laparotomy was performed via a peristomal incision with 5-mm skin margins, and the tumor was covered by a surgical glove to avoid any tumor seeding. The colon was separated from the tumor by 5-cm margins, and the specimen was removed en bloc. An end colostomy was constructed to a new site on the right side of the abdomen. The deficit in the abdominal wall was repaired, and the skin was closed via a purse-string suture. The final diagnosis of the stoma tumor was transverse colon cancer (T2, N0, M0, stage I). One year and five months after surgery, there was no evidence of recurrence.
  
  
  CONCLUSIONS
  The occurrence of carcinomas at colostomy sites in patients without a history of colorectal cancer is rare. It is important to train ostomates to monitor the stoma for possible tumor recurrence.
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan. maechiyo@hotmail.co.jp.
authors.forename: Chiyo
authors.initials: C
authors.lastname: Maeda
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan. ehidaka@med.showa-u.ac.jp.
authors.forename: Eiji
authors.initials: E
authors.lastname: Hidaka
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan. hmmmr5@yahoo.co.jp.
authors.forename: Mari
authors.initials: M
authors.lastname: Shimada
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan. sshoji1982@gmail.com.
authors.forename: Shoji
authors.initials: S
authors.lastname: Shimada
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan. ke_nakahara@yahoo.co.jp.
authors.forename: Kenta
authors.initials: K
authors.lastname: Nakahara
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan. dtakaya@med.showa-u.ac.jp.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Takayanagi
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan. yuutake47@yahoo.co.jp.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Takehara
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan. pei2surg@yahoo.co.jp.
authors.forename: Shumpei
authors.initials: S
authors.lastname: Mukai
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan. naruhiko@med.showa-u.ac.jp.
authors.forename: Naruhiko
authors.initials: N
authors.lastname: Sawada
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan. fumio182@med.showa-u.ac.jp.
authors.forename: Fumio
authors.initials: F
authors.lastname: Ishida
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan. kudos@med.showa-u.ac.jp.
authors.forename: Shin-ei
authors.initials: SE
authors.lastname: Kudo
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000209:etiology*; D000369:Aged, 80 and over; D044684:Colon, Transverse / Q000473:pathology*; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000209:etiology*; D003125:Colostomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D011379:Prognosis; D014057:Tomography, X-Ray Computed