Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 5/2020

01-05-2020 | Metastasis | Case Report

Ileostomy adenocarcinoma in Crohn’s disease

Authors: Ahmed Yousaf, Colleen Beatty, Zachary Zinn, Riaz Cassim, Swapna Gayam

Published in: International Journal of Colorectal Disease | Issue 5/2020

Login to get access

Abstract

Purpose

Adenocarcinoma of an ileostomy is rare with less than 50 reported cases in the literature. Ileostomy adenocarcinoma in Crohn’s disease is even more rare, with only 4 reported cases. We present a case of ileostomy adenocarcinoma with lymph node metastasis occurring 51 years after proctocolectomy and Brooke ileostomy in a female with Crohn’s disease. This case represents the longest documented interval between Brooke ileostomy and ileostomy adenocarcinoma diagnosis and summarizes clinical signs that warrant biopsy of a peristomal plaque to differentiate adenocarcinoma from clinical mimics such as pyoderma gangrenosum (PG).

Methods

Clinical, histological, and surgical patient data were reviewed. A literature review of adenocarcinoma arising from ileostomy sites was performed.

Results

We report a case of a 67-year-old woman that presented with a peristomal skin lesion developing over 10 years. After multidisciplinary discussion between gastroenterology, colorectal surgery, and dermatology, ileoscopy revealed moderately differentiated, invasive adenocarcinoma arising from the ileostomy site. Wide surgical excision and en bloc resection of the peristomal lesions were performed, and the final pathology revealed lymph node metastasis. The patient is currently undergoing adjuvant chemotherapy.

Conclusions

Clinicians should maintain a high level of suspicion when ileostomy patients develop a peristomal lesion.
Literature
1.
Metzger PP, Slappy AJ, Chua HK, Menke DM (2008) Adenocarcinoma developing at an ileostomy: report of a case and review of the literature. Dis Colon Rectum 51(5):604–609CrossRef
2.
Brooke B (1952) The management of an ileostomy: including its complications. Lancet 260(6725):102–104CrossRef
3.
Gadacz T, McFadden D, Gabrielson E, Ullah A, Berman J (1990) Adenocarcinoma of the ileostomy: the latent risk of cancer after colectomy for ulcerative colitis and familial polyposis. Surgery 107(6):698–703PubMed
4.
Sigler L, Jedd FL (1969) Adenocarcinoma of the ileostomy occurring after colectomy for ulcerative colitis. Dis Colon Rectum 12(1):45–48CrossRef
5.
Suarez V, Alexander-Williams J, O'Connor HJ, Campos A, Fuggle WJ, Thompson H, Enker WE, Greenstein AJ (1988) Carcinoma developing in ileostomies after 25 or more years. Gastroenterology 95(1):205–208CrossRef
6.
Goligher JC (1980) Surgery of the anus, rectum and colon. Bailliere Tindall, London, pp 924–925
7.
Todd IP (1982) Mechanical complications of ileostomy. Clin Gastroenterol 11:268–273PubMed
8.
Liu K, Prasad MA, Lo A, Bellaguarda E, Strong S, Hanauer SB (2016) Primary adenocarcinoma of an ileostomy in Crohn's disease. ACG case reports journal 3(4):e112CrossRef
9.
Quah H, Samad A, Maw A (2005) Ileostomy carcinomas a review: the latent risk after colectomy for ulcerative colitis and familial adenomatous polyposis. Color Dis 7(6):538–544CrossRef
10.
Mimura T, Kuramoto S, Yamasaki K, Kaminishi M (1999) Familial adenomatous polyposis: a case report and histologic mucin study. J Clin Gastroenterol 28(4):372–376CrossRef
11.
Attanoos R, Billings P, Hughes L, Williams G (1995) Ileostomy polyps, adenomas, and adenocarcinomas. Gut 37(6):840–844CrossRef
Metadata
Title
Ileostomy adenocarcinoma in Crohn’s disease
Authors
Ahmed Yousaf
Colleen Beatty
Zachary Zinn
Riaz Cassim
Swapna Gayam
Publication date
01-05-2020
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 5/2020
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-020-03554-6

Other articles of this Issue 5/2020

International Journal of Colorectal Disease 5/2020 Go to the issue

Case Report

Pneumatosis cystoides intestinalis induced by the alpha-glucosidase inhibitor complicated from sigmoid volvulus in a diabetic patient

Clinical Study Protocol

Efficacy of screening using annual fecal immunochemical test alone versus combined with one-time colonoscopy in reducing colorectal cancer mortality: the Akita Japan population-based colonoscopy screening trial (Akita pop-colon trial)

Letter to the Editor

Five-year survival of patients in control groups of randomized controlled trials is much higher than that assumed in observational study reports

Original Article

Safety and efficacy of cold snare polypectomy for pedunculated (Ip) polyps measuring less than 10 mm in diameter

Original Article

Prevention of anastomotic leak in rectal cancer surgery with local antibiotic decontamination: a prospective, randomized, double-blind, placebo-controlled single center trial

Original Article

A real world analysis of recurrence risk factors for early colorectal cancer T1 treated with standard endoscopic resection