Development of Two Cancers in the Same Patient after Ileorectal and Ileal Pouch Anal Anastomosis for Familial Adenomatous Polyposis

Ulaş, Murat; Neşşar, Gürel; Bostanoğlu, Akın; Aydog, Gulden; Kayaalp, Cüneyt; Özoğul, Yusuf Bayram; Seven, Canbek

doi:10.1159/000089393

Cited by 13 publications

(8 citation statements)

References 22 publications

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“…The main reason favoring IPAA compared to IRA is that IPAA would theoretically reduce the risk of rectal cancer development to a greater degree than IRA. However, the prevalence of two cases of ileal pouch adenocarcinoma (6.5%) as reported here, combined with previous reports, [14][15][16][17][18] might explode the established theory that IPAA is a definite treatment. But the potential risk cannot be compared to the risk of rectal cancer after IRA because the sample sizes are so small.…”

Section: Discussionsupporting

confidence: 59%

“…32 To our knowledge, there have been five case reports of adenocarcinoma arising from the ileal pouch mucosa. [14][15][16][17][18] Our cases are the sixth and seventh cases of ileal pouch cancer described in the English literature (Table 4). It is not clear what malignant potential pouch adenoma may have and what is the lifetime risk of pouch cancer be for patients with FAP.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9][10][11][12][13] In addition, there were five reports of cancers arising from the ileal pouch mucosa, as opposed to from the anastomosis, in patients with FAP. [14][15][16][17][18] In our center, patients with FAP underwent Kock pouch construction or an IRA until 1987. However, since the introduction of IPAA in our center in 1988, we have favored IPAA as the operation of first choice for the treatment of patients with FAP.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of Adenomas and Carcinomas in the Ileal Pouch After Proctocolectomy in Patients with Familial Adenomatous Polyposis

Tajika

Nakamura

Nakahara

et al. 2009

Journal of Gastrointestinal Surgery

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence of Adenomas and Carcinomas in the Ileal Pouch After Proctocolectomy in Patients with Familial Adenomatous Polyposis

Tajika

Nakamura

Nakahara

et al. 2009

Journal of Gastrointestinal Surgery

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“…This review includes reports of carcinomas appearing not only in the residual rectal mucosa or anastomosis after IRA (10–31%) but also in the ileal pouch body mucosa after Kock or IPAA (8–62%). 2930313233344, 35–38 …”

Section: Introductionmentioning

confidence: 99%

Adenocarcinomas after Prophylactic Surgery for Familial Adenomatous Polyposis

Smith¹,

Schaffer²,

Ballard³

et al. 2013

JCT

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The incidence of familial adenomatous polyposis (FAP) is one in 7,000 to 12,000 live births. Virtually, all surgically untreated patients with FAP inevitably develop colorectal-cancer in their lifetime because they carry the adenomatous polyposis coli gene. Thus prophylactic proctocolectomy is indicated. Surgical treatment of FAP is still controversial. There are however, four surgical options: ileorectal anastomosis, restorative proctocolectomy with ileal pouch-anal anastomosis, proctocolectomy with ileostomy, and proctocolectomy with continent-ileostomy. Conventional proctocolectomy options largely lie between colectomy with ileorectal anastomosis or ileal pouch-anal anastomosis. Detractors of ileal pouch-anal anastomosis prefer ileorectal anastomosis because of better functional results and quality of life. The functional outcome of total colectomy with ileorectal anastomosis is undoubtedly far superior to that of the ileoanal pouch; however, the risk for rectal cancer is increased by 30%. Even after mucosectomy, inadvertent small mucosal residual islands remain. These residual islands carry the potential for the development of subsequent malignancy. We reviewed the literature (1975–2012) on the incidence, nature, and possible etiology of subsequent ileal-pouch and anal transit zone adenocarcinoma after prophylactic surgery procedure for FAP. To date there are 24 studies reporting 92 pouch-related cancers; 15 case reports, 4 prospective and 5 retrospective studies. Twenty three of 92 cancers (25%) developed in the pouch mucosa and 69 (75%) in anal transit zone (ATZ). Current recommendation for pouch surveillance and treatment are presented. Data suggest lifetime surveillance of these patients.

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“…In familial adenomatous polyposis (FAP), the subsequent development of adenocarcinoma in ileal pouch, residual rectal mucosa in the anal canal or anastomotic site have been reported (1-11). …”

Section: Introductionmentioning

confidence: 99%

Adenocarcinoma in Ileal Pouch after Proctocolectomy for Familial Adenomatous Polyposis: Report of A Case

et al. 2009

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Restorative proctocolectomy with ileal pouch-anal anastomosis is one of the surgical treatments of choice for patients with familial adenomatous polyposis. Although the risk of cancer developing in an ileal pouch is not yet clear, a few cases of adenocarcinoma arising in an ileal pouch have been reported. We report a case of adenocarcinoma in ileal pouch after proctocolectomy with ileal pouch-anal anastomosis. A 56-yr-old woman was diagnosed as having familial adenomatous polyposis. Total colectomy with ileorectal anastomosis was performed. Six years later, she underwent completion-proctectomy with ileal J pouch-anal anastomosis including anorectal mucosectomy for rectal cancer. After 7 yr, she presented with anal spotting. Endoscopic biopsies revealed adenocarcinoma at the ileal pouch. Resection of the ileal pouch and permanent ileostomy were performed. The risk of cancer in an ileal pouch and its prevention with regular surveillance must be emphasized.

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Development of Two Cancers in the Same Patient after Ileorectal and Ileal Pouch Anal Anastomosis for Familial Adenomatous Polyposis

Cited by 13 publications

References 22 publications

Prevalence of Adenomas and Carcinomas in the Ileal Pouch After Proctocolectomy in Patients with Familial Adenomatous Polyposis

Prevalence of Adenomas and Carcinomas in the Ileal Pouch After Proctocolectomy in Patients with Familial Adenomatous Polyposis

Adenocarcinomas after Prophylactic Surgery for Familial Adenomatous Polyposis

Adenocarcinoma in Ileal Pouch after Proctocolectomy for Familial Adenomatous Polyposis: Report of A Case

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