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Adenocarcinoma at the site of ileoanal anastomosis in Crohn's disease

Report of a case

  • Case Reports
  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: Proctocolectomy with ileoanal anastomosis has gained acceptance for the treatment of patients with ulcerative colitis. However, there are some patients with Crohn's disease who received ileoanal anastomosis, because some Crohn's colitis is difficult to differentiate from ulcerative colitis. The risk of cancer development at the site of ileoanal anastomosis has not been emphasized in Crohn's disease. METHODS: A 12-year-old patient with Crohn's disease was treated by proctocolectomy with straight ileoanal anastomosis. Twenty-five years after the operation, the patient noticed the tumor that developed at the site of ileoanal anastomosis. RESULTS: This article presents a patient with Crohn's disease who developed invasive adenocarcinoma at the site of ileoanal anastomosis 25 years after proctocolectomy with ileoanal anastomosis. CONCLUSIONS: An ileoanal anastomosis does not eliminate the risk of cancer development, and surveillance after this operation seems advisable.

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References

  1. Orkin BA, Telander RL, Wolff BG, Perrault J, Ilustrup DM. The surgical management of children with ulcerative colitis: the oldvs. the new. Dis Colon Rectum 1990;33:947–55.

    Google Scholar 

  2. Stern H, Walfisch S, Mullen B, McLeod R, Cohen Z. Cancer in an ileoanal reservoir: a new late complication? Gut 1990;31:473–5.

    Google Scholar 

  3. Puthu D, Rajan N, Rao R, Rao L, Venugopa P. Carcinoma of the rectal pouch following restorative proctocolectomy: report of a case. Dis Colon Rectum 1992;35:257–60.

    Google Scholar 

  4. Hoehner JC, Metcalf AM. Development of invasive adenocarcinoma following colectomy with ileoanal anastomosis for familial polyposis coli: report of a case. Dis Colon Rectum 1994;37:824–8.

    Google Scholar 

  5. Rodriguez-Sanjuan JC, Polavieja MG, Naranjo A, Castillo J. Adenocarcinoma in an ileal pouch for ulcerative colitis. Dis Colon Rectum 1995;38:779–80.

    Google Scholar 

  6. von Herbay A, Stern J, Herfarth C. Puch-anal cancer after restorative proctocolectomy for familial adenomatous polyposis. Am J Surg Pathol 1996;20:995–9.

    Google Scholar 

  7. Vieth M, Grunewald M, Niemeyer C, Stolte M. Adenocarcinoma in an ileal pouch after prior proctocolectomy for carcinoma in a patient with ulcerative pancolitis. Virchows Arch 1998;433:281–4.

    Google Scholar 

  8. Soave F. A new surgical technique for treatment of Hirschsprung's disease. Surgery 1964;56:1007–12.

    Google Scholar 

  9. Pemberton JH, Kelly KA, Beart RW Jr, Dozois RR, Wolff BG, Ilstrup DM. Ileal pouch-anal anastomosis for chronic ulcerative colitis: long term results. Ann Surg 1987;206:504–13.

    Google Scholar 

  10. Heppell J, Weiland LH, Perrault J, Pemberton JH, Telander RL, Beart RW Jr. Fate of the rectal mucosa after rectal mucosectomy and ileoanal anastomosis. Dis Colon Rectum 1983;26:768–71.

    Google Scholar 

  11. O'Connell PR, Pemberton JH, Weiland LH,et al. Does rectal mucosa regenerate after ileoanal anastomosis? Dis Colon Rectum 1987;30:1–5.

    Google Scholar 

  12. Ribeiro MB, Greenstein AJ, Sachar DB,et al. Colorectal adenocarcinoma in Crohn's Disease. Ann Surg 1996;223:186–93.

    Google Scholar 

  13. Shepherd NA, Healey CJ, Warren BF, Richman PI, Thompson WH, Wilkinson SP. Distribution of mucosal pathology and an assessment of colonic phenotypic changes in the pelvic ileal reservoir. Gut 1993;34:101–5.

    Google Scholar 

  14. Viamonte M, Viamonte M. Primary squamous-cell carcinoma of the small bowel: report of a case. Dis Colon Rectum 1992;35:806–9.

    Google Scholar 

  15. Veress B, Reinholt FP, Lindquist K, Loefberg R, Liljeqvist L. Long-term histomorphological surveillance of the pelvic ileal pouch: dysplasia develops in a subgroup of patients. Gastroenterology 1995;109:1090–7.

    Google Scholar 

  16. Ravitch MM. The reception of new operations. Ann Surg 1984;200:231–46.

    Google Scholar 

  17. Suarez V, Alexander-Williams J, O'Connor HJ,et al. Carcinoma developing in ileostomies after 25 or more years. Gastroenterology 1988;95:205–8.

    Google Scholar 

  18. Starke J, Rodriguez-Bigas M, Marshall W, Sohrabi A, Petrelli NJ. Primary adenocarcinoma arising in an ileostomy. Surgery 1993;114:125–8.

    Google Scholar 

  19. Attanoos R, Billings PJ, Hughes LE, Williams GT. Ileostomy polyps, adenomas, and adenocarcinomas. Gut 1995;37:840–4.

    Google Scholar 

  20. Cox CL, Butts DR, Roberts MP, Wessels RA, Bailey HR. Development of invasive adenocarcinoma in a long-standing Kock continent ileostomy: report of a case. Dis Colon Rectum 1997;40:500–3.

    Google Scholar 

  21. Gadacz TR, McFadden DW, Gabrielson EW, Ullah A, Berman JJ. Adenocarcinoma of the ileostomy: the latent risk of cancer after colectomy for ulcerative colitis and familial polyposis. Surgery 1990;107:698–703.

    Google Scholar 

  22. Gilson TP, Sollenberger LL. Adenocarcinoma of an ileostomy in a patient with familial adenomatous polyposis: report of a case. Dis Colon Rectum 1992;35:261–5.

    Google Scholar 

  23. Sherlock DJ, Suarez V, Gray JG. Stomal adenocarcinoma in Crohn's disease. Gut 1990;31:1329–32.

    Google Scholar 

  24. Senay E, Sachar DB, Koehane M, Greenstein AJ. Small bowel carcinoma in Crohn's disease: distinguishing features and risk factors. Cancer 1989;63:360–3.

    Google Scholar 

  25. Richards ME, Rickert RR, Nance FC. Crohn's disease-associated carcinoma: a poorly recognized complication of inflammatory bowel disease. Ann Surg 1989;209:764–73.

    Google Scholar 

  26. Ribeiro MB, Greenstein AJ, Heimann TM, Yamazaki Y, Aufses AH Jr. Adenocarcinoma of the small intestine in Crohn's disease. Surg Gynecol Obstet 1991;173:343–9.

    Google Scholar 

  27. Lashner BA. Risk factors for small bowel cancer in Crohn's disease. Dig Dis Sci 1992;37:1179–84.

    Google Scholar 

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Kotanagi, H., Kon, H., Iida, M. et al. Adenocarcinoma at the site of ileoanal anastomosis in Crohn's disease. Dis Colon Rectum 44, 1210–1213 (2001). https://doi.org/10.1007/BF02234646

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  • DOI: https://doi.org/10.1007/BF02234646

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