Malignant melanoma of the ileo-anal pouch anastomosis after restorative proctocolectomy for ulcerative colitis: report of a case

Abstract

A 62 year-old patient with therapy-refractory pouchitis after proctocolectomy for ulcerative colitis was admitted with hematochezia and abdominal discomfort. A malignant melanoma (MM) was found after repeated biopsies of the pouch. Complete staging revealed no evidence for distant metastases and the patient underwent abdominoperineal pouch resection. Six weeks later, the patient was readmitted because of severe general deterioration and diffuse metastatic spread to the liver was found. The patient died of hepatorenal syndrome shortly thereafter.Patients with inflammatory bowel disease are at increased risk of developing cancer, including rarities such as MM. Our experience stresses the importance of repeated biopsies in therapy-refractory pouchitis.

Incidence and Risk Factors of Cancer in the Anal Transitional Zone and Ileal Pouch following Surgery for Ulcerative Colitis and Familial Adenomatous Polyposis

“…However, other studies found no link with pouch dysplasia [87]. More anecdotally, other pouch and ATZ malignancies have been reported such as squamous cell carcinoma [63,66,69,[106][107][108][109][110], pouch lymphoma [29,63,99,[111][112][113][114][115][116][117], carcinoid tumour of the pouch [118,119] and malignant melanoma [120]. Moreover, the Danish nationwide cohort found a higher risk of non-melanoma skin and hepatobiliary cancers in patients undergoing IPAA for UC than in the gender-and age-matched comparison cohort of patients from a national civil database [106].…”