title: Cancer arising from the remnant mucosa of the ileoanal anastomosis leading to pouchectomy.
abstract: Ileal pouch-related adenocarcinoma remains a rarity; thus, guidelines on treatment are currently lacking. We present this case of a 54-year-old man who underwent restorative proctocolectomy with stapled ileal pouch-anal anastomosis formation for familial adenomatous polyposis during the 1980s. Despite undergoing annual surveillance endoscopy, the patient was noted to be anaemic and passing fresh blood per anus Endoscopy and radiological investigation revealed the presence of a pouch-related adenocarcinoma. This was subsequently treated with short-course radiotherapy and pouch excision. The patient remains well until now and will follow six-monthly surveillance protocols with a transition to annual surveillance after 2 years.
authors.affiliation: Department of Surgery, University Hospital Limerick, Limerick, Limerick, Ireland Department of Surgery, University of Limerick GEMS, Limerick, Limerick, Ireland.
authors.forename: Leon Gearoid
authors.initials: LG
authors.lastname: Walsh
authors.affiliation: Department of Radiology, University Hospital Limerick, Limerick, Limerick, Ireland.
authors.forename: Bryan J
authors.initials: BJ
authors.lastname: Kenny
authors.affiliation: Cancer Centre, University Hospital Limerick, Limerick, Limerick, Ireland.
authors.forename: Mazen
authors.initials: M
authors.lastname: El Bassiouni
authors.affiliation: Department of Surgery, University Hospital Limerick, Limerick, Limerick, Ireland Department of Surgery, University of Limerick GEMS, Limerick, Limerick, Ireland Centre for Interventions in Infection, Inflammation and Immunity, Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
authors.forename: John Calvin
authors.initials: JC
authors.lastname: Coffey
mesh_terms: D000230:Adenocarcinoma / Q000209:etiology* / Q000601:surgery; D011125:Adenomatous Polyposis Coli / Q000601:surgery; D039021:Colonic Pouches / Q000009:adverse effects*; D006801:Humans; D007078:Ileal Neoplasms / Q000209:etiology* / Q000601:surgery; D007081:Ileostomy / Q000009:adverse effects*; D007082:Ileum / Q000473:pathology / Q000601:surgery; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016737:Proctocolectomy, Restorative / Q000009:adverse effects*