Procaccino L, Rehman S, Abdurakhmanov A, McWhorter P, La Gamma N, Bhaskaran MC, Maurer J, Grimaldi GM, Rilo H, Nicastro J, Coppa G, Molmenti EP, Procaccino J. Adenocarcinoma arising at ileostomy sites: Two cases and a review of the literature. World J Gastrointest Surg 2015; 7(6): 94-97 [PMID: 26131331 DOI: 10.4240/wjgs.v7.i6.94]
Corresponding Author of This Article
Ernesto P Molmenti, MD, PhD, MBA, Department of Surgery, North Shore University Hospital, 300 Community Drive, Manhasset, NY 11030, United States. emolment@nshs.edu
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Jun 27, 2015; 7(6): 94-97 Published online Jun 27, 2015. doi: 10.4240/wjgs.v7.i6.94
Adenocarcinoma arising at ileostomy sites: Two cases and a review of the literature
Lauren Procaccino, Sameer Rehman, Alexander Abdurakhmanov, Peter McWhorter, Nicholas La Gamma, Madhu C Bhaskaran, James Maurer, Gregory M Grimaldi, Horacio Rilo, Jeffrey Nicastro, Gene Coppa, Ernesto P Molmenti, John Procaccino
Lauren Procaccino, Sameer Rehman, Alexander Abdurakhmanov, Peter McWhorter, Nicholas La Gamma, Madhu C Bhaskaran, James Maurer, Gregory M Grimaldi, Horacio Rilo, Jeffrey Nicastro, Gene Coppa, Ernesto P Molmenti, John Procaccino, Department of Surgery, North Shore University Hospital, Manhasset, NY 11030, United States
Author contributions: Procaccino L made the initial research and reviewed the manuscript; Rehman S and Abdurakhmanov A contributed to researching, reviewing the manuscript, the manuscript composition and patient care; Abdurakhmanov A collected the data; McWhorter P contributed to reviewing the manuscript and the photography credit; La Gamma N, Bhaskaran MC, Rilo H, Nicastro J and Coppa G reviewed, edited and researched the manuscript; Maurer J contributed to reviewing and editing the manuscript and patient care; Grimaldi GM contributed to the radiology interpretation and image credit, and reviewing and editing the manuscript; Molmenti EP reviewed, edited, designed, researched the manuscript; Procaccino J made the initial idea to do literature search and surgery, and contributed to reviewing and editing the manuscript and patient care.
Ethics approval: These case reports and literature review did not require IRB approval. Patient confidentiality was maintained.
Conflict-of-interest: We report no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ernesto P Molmenti, MD, PhD, MBA, Department of Surgery, North Shore University Hospital, 300 Community Drive, Manhasset, NY 11030, United States. emolment@nshs.edu
Telephone: +1-516-4725800 Fax: +1-516-4725805
Received: August 30, 2014 Peer-review started: August 30, 2014 First decision: November 27, 2014 Revised: December 29, 2014 Accepted: May 5, 2015 Article in press: May 6, 2015 Published online: June 27, 2015
Abstract
Total colectomy with ileostomy placement is a treatment for patients with inflammatory bowel disease or familial adenomatous polyposis (FAP). A rare and late complication of this treatment is carcinoma arising at the ileostomy site. We describe two such cases: a 78-year-old male 30 years after subtotal colectomy and ileostomy for FAP, and an 85-year-old male 50 years after colectomy and ileostomy for ulcerative colitis. The long latency period between creation of the ileostomies and development of carcinoma suggests a chronic metaplasia due to an irritating/inflammatory causative factor. Surgical excision of the mass and relocation of the stoma is the mainstay of therapy, with possible benefits from adjuvant chemotherapy. Newly developed lesions at stoma sites should be biopsied to rule out the possibility of this rare ileostomy complication.
Core tip: A rare and late complication of ileostomy creation is carcinoma arising from the ileostomy site. Physicians and patients should be aware of this phenomenon and require regular physical exams. Any and all parastomal lesions should be biopsied to rule out adenocarcinoma at the ileostomy site.
