Ileostomy cancer in familial adenomatous polyposis

Published: 04/19/2012

Authors: Mackey PM, Al-Quedo A and Stephenson BM

A 59-year old woman, who had undergone a panproctocolectomy for familial adenomatous coli 33 years previously, presented with a fast growing 6 cm friable nodular mass adjacent to the ileostomy. A computed tomograph showed no evidence of spread and she underwent a wide local excision and in-situ re-fashioning of the stoma. Histology demonstrated a completely excised moderately differentiated adenocarcinoma. Ileostomy carcinomas are rare and their aetiology remains speculative, with the interval between ileosotomy formation and development of invasive malignancy usually over 20 years. Traditionally wide resection and re-siting was deemed necessary but local excision may be successful in early cases.