Published online Jun 27, 2015. doi: 10.4240/wjgs.v7.i6.94
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
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.