Adenocarcinoma arising at ileostomy sites: Two cases and a review of the literature

Procaccino, Lauren; Rehman, Sameer; Abdurakhmanov, Alexander; McWhorter, Peter; Gamma, Nicholas La; Bhaskaran, Madhu; Maurer, James; Grimaldi, Gregory; Rilo, Horacio; Nicastro, Jeffrey; Coppa, Gene F.; Molmenti, Ernesto P.; Procaccino, J

doi:10.4240/wjgs.v7.i6.94

Cited by 8 publications

(7 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It has been hypothesized that colonic metaplasia occurs when the intestinal mucosa of an ileostomy is exposed to chronic inflammation, creating a cycle of mucosal damage and repair. This could occur through trauma, poorly fitting or irritating stomal appliances, or other changes in the environment of the ileostomy . How colonic metaplasia becomes intraepidermal is unknown.…”

Section: Discussionmentioning

confidence: 99%

“…The first reported case of primary adenocarcinoma arising from an ileostomy site occurred in 1969 in a patient with longstanding UC . Since then, approximately 42 cases of ileostomy site primary adenocarcinoma have been reported in the literature in individuals with IBD or familial adenomatous polyposis . These malignant changes only arose after decades of stoma use.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Benign colonic metaplasia at a previous stoma site in a patient without adenomatous polyposis

et al. 2015

View full text Add to dashboard Cite

There are few reported cases of cutaneous intestinal metaplasia or primary adenocarcinoma arising at the ileostomy site following panproctocolectomy. These complications have been seen almost exclusively in patients with familial adenomatous polyposis and inflammatory bowel disease (IBD). However, benign intraepidermal colonic mucosa at a reversed ileostomy site in a patient without familial adenomatous polyposis or IBD has not been documented. We report a case of a 51-year-old female with a history of colonic adenocarcinoma who presented with pruritic, erythematous, scaly plaques on the right lower abdomen, present since reversal of her ileostomy in 2007. Skin biopsy revealed benign foci of colonic epithelium with no evidence of adenomatous change. Benign intraepidermal colonic mucosa was diagnosed based on histopathologic findings and immunohistochemistry. To our knowledge, this is the first case of intraepidermal benign colonic metaplasia forming in a patient following ostomy reversal. The case emphasizes the importance of patient education and physical examination of the stoma or stoma remnants for detection of unusual or changing lesions due to the risk for malignant transformation. It also demonstrates that benign colonic mucosa should be considered in the differential diagnosis when evaluating lesions near ileostomy sites, regardless of whether the patient has a history of familial adenomatous polyposis or IBD.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Benign colonic metaplasia at a previous stoma site in a patient without adenomatous polyposis

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Similarly, adenocarcinoma arising at an ileostomy site is a rare complication after colectomy and ileostomy formation for inflammatory bowel disease (ulcerative colitis, Crohn's disease) or familial adenomatous polyposis (FAP) [6][7][8][9]. The precise etiology of ileostomy carcinomas remains unclear, but colonic metaplasia from chronic inflammation has been considered to be correlated.…”

Section: Discussionmentioning

confidence: 99%

“…According to the literature, ileostomy adenocarcinomas usually demonstrate fungating, exophytic growths involving the mucosa of the ileostomy [6][7][8][9]. Clinically, they can appear in various forms such as chronic ulcers or protruding masses.…”

Section: Discussionmentioning

confidence: 99%

Adenocarcinoma Arising at a Urostomy: Case Report and Literature Review

2020

View full text Add to dashboard Cite

We report a case of adenocarcinoma originating in a urostomy site 35 years after bladder cancer operation and urostomy formation. While ileostomy adenocarcinoma has been reported as a rare complication after colectomy and ileostomy formation for inflammatory bowel disease or familial adenomatous polyposis, there were no previously published cases of parastomal carcinoma in patients with urostomy. In our case, a series of work-ups, including immunohistochemical staining (cytokeratin 7 and 20, p63), revealed no evidence of primary adenocarcinoma of the skin or any other primary tumor. The patient underwent surgical excision with urostomy reformation and the skin defect was successfully reconstructed using local flap and split-thickness skin graft. This case poses a diagnostic challenge for clinicians because skin primary adenocarcinoma (i.e., malignant adnexal tumor) is likely to be ruled out due to its low incidence, and the symptoms may be considered those of a rare subcutaneous metastasis from a visceral malignancy (e.g., colon cancer) in the patient with a history of a prior malignancy (bladder cancer). This underscores the need for a multidisciplinary approach and patient education for early diagnosis.

show abstract

“…Hence, polyp development long after surgery usually warrants a biopsy and pathological evaluation. 44,45 Peristomal Fistula, Ulceration, IBD…”

Section: Peristomal Skin Irritation and Infectionmentioning

confidence: 99%

Ostomy Complications in Crohn's Disease

Aboulian

2019

Clinics in Colon and Rectal Surgery

View full text Add to dashboard Cite

Ostomy creation is a routine surgical procedure that has earned its place high in the surgeon's armamentarium in dealing with challenging situations. However, it is not without its complications. In this article, we review the common complications including parastomal hernia, prolapse, mucocutaneous junction separation with ischemia and stenosis, peristomal skin conditions, and infections. Additionally, we review conditions that arise in association with underlying Crohn's disease, such as peristomal inflammation, fistula formation, and pyoderma gangrenosum.

show abstract

Adenocarcinoma arising at ileostomy sites: Two cases and a review of the literature

Cited by 8 publications

References 8 publications

Benign colonic metaplasia at a previous stoma site in a patient without adenomatous polyposis

Benign colonic metaplasia at a previous stoma site in a patient without adenomatous polyposis

Adenocarcinoma Arising at a Urostomy: Case Report and Literature Review

Ostomy Complications in Crohn's Disease

Contact Info

Product

Resources

About