Ileostomy Adenocarcinoma A Case Report

Malta medical journal

Godfrey La Ferla¹  JoEtienne Abela¹  Marcin J Szczepanski¹ 

关键词: Ulcerative colitis;    ileostomy;    adenocarcinoma;    colonic metaplasia;   

DOI  :  

学科分类：医学（综合）

来源: University of Malta * Medical School

【 摘 要 】

Proctocolectomy is the standard treatment for patients suffering from ulcerative colitis which is long-standing, refractory to pharmacotherapy or otherwise associated with complications. An ileal pouch with pouch-anal anastomosis is fashioned in the majority of cases; however, in some instances terminal ileostomy is preferable. Ileostomy cancer is rare but a number of cases have been reported over the past twenty years suggesting a rising incidence. We report a case that developed thirty years post-operatively. lymph nodes. Excision biopsy of the lesion and the adjacent indurated skin was performed. Histologically, the lesion was a carcinoma made up of colonic-type glands, which invaded deep into the submucosa and infiltrated the adjacent skin. Stromal pools of mucin were a prominent feature. Immunohistochemical staining confirmed that the lesion was of local origin rather than a metastasis. Therefore, the pathological diagnosis was of a primary well-differentiated mucinous adenocarcinoma with local skin invasion. A CT scan of the abdomen and pelvis was performed to stage the disease. It confirmed the absence of metastases. The patient underwent wide local excision of the stomal site and resection of the terminal 12cm of ileum. An ileostomy was refashioned. She made an uneventful recovery and was discharged home six days after surgery. Histology of the excised skin and bowel revealed a background of chronic inflammation and colonic metaplasia in the mucocutaneous area. There was no evidence of residual neoplasia.

【 授权许可】

Unknown