Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
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.
Informed consent: Patients provided informed consent.
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.

Keywords: Ileostomy, Carcinoma, Adenocarcinoma, Familial adenomatous polyposis, Inflammatory bowel disease, Complication of ileostomy

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.