CLINICAL CASES   

Chirurgia 2009 February;22(1):39-41

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Adenocarcinoma arising at an ileostomy site: an unusual and late complication of ulcerative colitis

Ismail I., Navarra G. G., Grassi A., Bonomi S., Virzì S.

Divisione di Chirurgia Generale Ospedale di Bentivoglio Azienda ASL di Bologna, Bentivoglio Bologna, Italia

Ileostomy carcinoma is rare. There are no more than 35 published cases in literature of adenocarcinoma at an ileostomy site after proctocolectomy for ulcerative colitis. The authors describe a new case of adenocarcinoma at the ileostomy site, occuring 38 years after proctocolectomy and mucosectomy for ulcerative colitis in a 84-year-old man who was referred for evaluation of a 8 cm mass arising from ileostomy. A biospsy specimen of the mass revealed mucinous adenocarcinoma. The patient subsequently underwent a surgery and the ileostomy carcinoma and a surrounding 14 cm margin of skin and subcutaneous tissue were excited with a 20 cm length of ileum with mesentery, a new ileostomy was constructed.
Histologic examination revealed a mucinous poorly differentiated adenocarcinoma arising from the ileostomy and invading the surrounding skin and the subcutaneous tissue, the tumore size was 8 cm in its greater diameter. No evidence was found of mesenteric lymph node involvement in the resected speciemen. The margins of the resected specimen were non infiltrated by tumor. The authors discuss the clinical and pathological aspects, the diagnosis and the causes of the formation of adenocarcinoma at an ileostomy site and they recommend a correct follow-p of patients operated for ulcerative colitis.