Adenocarcinoma of the ileoanal pouch anastomosis: an emerging complication?

被引:40
作者
Hassan, C
Zullo, A
Speziale, G
Stella, F
Lorenzetti, R
Morini, S
机构
[1] Nuovo Regina Margherita Hosp, Dept Gastroenterol, I-00153 Rome, Italy
[2] Nuovo Regina Margherita Hosp, Dept Surg, I-00153 Rome, Italy
[3] Nuovo Regina Margherita Hosp, Dept Pathol, I-00153 Rome, Italy
关键词
ulcerative colitis; ileoanal pouch anastomosis; cancer;
D O I
10.1007/s00384-002-0452-1
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background and aims: Restorative proctocolectomy with ileoanal pouch anastomosis (IPAA) is currently the surgical treatment of choice for ulcerative colitis. Although dysplastic changes to the native ileal mucosa of the pouch occur in a subgroup of patients with severe chronic pouchitis, the development of cancer in the pouch itself is a very rare event. To date, only two cases of carcinoma of the IPAA have been reported, namely in patients operated on for colon cancer complicating ulcerative colitis and with a previous diagnosis of backwash ileitis. Case report: We report a patient with carcinoma in an ileoanal pouch who had been suffering from chronic atrophic pouchitis early after surgery. He had no previous history of colon cancer or backwash ileitis. The adenocarcinoma was detected 22 months after IPAA, and it was deeply infiltrating the adjacent structures (pT4N0M0, grade 2). Histology revealed the passage from chronic atrophic pouchitis to dysplastic epithelium and to cancer. Conclusion: Our case suggests that malignant transformation of the IPAA may occur as a pure complication of the severe chronic pouchitis, even in the absence of backwash ileitis or a previous history of colon cancer.
引用
收藏
页码:276 / 278
页数:3
相关论文
共 12 条
[1]   PROSPECTIVE EVALUATION OF EARLY MORPHOLOGICAL-CHANGES IN PELVIC ILEAL POUCHES [J].
APEL, R ;
COHEN, Z ;
ANDREWS, CW ;
MCLEOD, R ;
STEINHART, H ;
ODZE, RD .
GASTROENTEROLOGY, 1994, 107 (02) :435-443
[2]   ILEAL POUCH ANAL ANASTOMOSIS - REOPERATION FOR POUCH-RELATED COMPLICATIONS [J].
GALANDIUK, S ;
SCOTT, NA ;
DOZOIS, RR ;
KELLY, KA ;
ILSTRUP, DM ;
BEART, RW ;
WOLFF, BG ;
PEMBERTON, JH ;
NIVATVONGS, S ;
DEVINE, RM .
ANNALS OF SURGERY, 1990, 212 (04) :446-454
[3]   Neoplastic transformation of the pelvic pouch mucosa in patients with ulcerative colitis [J].
Gullberg, K ;
Stahlberg, D ;
Liljeqvist, L ;
Tribukait, B ;
Reinholt, FP ;
Veress, B ;
Lofberg, R .
GASTROENTEROLOGY, 1997, 112 (05) :1487-1492
[4]   Adenocarcinoma in the ileal pouch: late risk of cancer after restorative proctocolectomy [J].
Heuschen, UA ;
Heuschen, G ;
Autschbach, F ;
Allemeyer, EH ;
Herfarth, C .
INTERNATIONAL JOURNAL OF COLORECTAL DISEASE, 2001, 16 (02) :126-130
[5]   MUCOSECTOMY IN RESTORATIVE PROCTOCOLECTOMY [J].
OCONNELL, PR ;
WILLIAMS, NS .
BRITISH JOURNAL OF SURGERY, 1991, 78 (02) :129-130
[6]   POUCHITIS FOLLOWING ILEAL POUCH-ANAL ANASTOMOSIS - DEFINITION, PATHOGENESIS, AND TREATMENT [J].
SANDBORN, WJ .
GASTROENTEROLOGY, 1994, 107 (06) :1856-1860
[7]   CANCER IN AN ILEOANAL RESERVOIR - A NEW LATE COMPLICATION [J].
STERN, H ;
WALFISCH, S ;
MULLEN, B ;
MCLEOD, R ;
COHEN, Z .
GUT, 1990, 31 (04) :473-475
[8]   Risk of dysplasia in long-term ileal pouches and pouches with chronic pouchitis [J].
Thompson-Fawcett, MW ;
Marcus, V ;
Redston, M ;
Cohen, Z ;
McLeod, RS .
GASTROENTEROLOGY, 2001, 121 (02) :275-281
[9]   LONG-TERM HISTOMORPHOLOGICAL SURVEILLANCE OF THE PELVIC ILEAL POUCH - DYSPLASIA DEVELOPS IN A SUBGROUP OF PATIENTS [J].
VERESS, B ;
REINHOLT, FP ;
LINDQUIST, K ;
LOFBERG, R ;
LILJEQVIST, L .
GASTROENTEROLOGY, 1995, 109 (04) :1090-1097
[10]   Adenocarcinoma in an ileal pouch after prior proctocolectomy for carcinoma in a patient with ulcerative pancolitis [J].
Vieth, M ;
Grunewald, M ;
Niemeyer, C ;
Stolte, M .
VIRCHOWS ARCHIV-AN INTERNATIONAL JOURNAL OF PATHOLOGY, 1998, 433 (03) :281-284