A Case of Adenocarcinoma of the Small Intestine Arising in the Anastomosis of Ileostomy for Familial Adenomatous Polyposis.

Makoto Yoshida, Hideaki Kawashima, Takashi Hara, Masahiro Ishigo-oka, Motoya Kashiyama, Setsuji Takanashi, Takashi Gotoh, Toshiro Kan, Hiromi Hatakeyama and Sayuki Yamazaki

Department of Surgery, Kin-i-kyo Chyu-ou Hospital

A 34-year-old woman underwent prophylactic total proctocolorectomy with an ileal J pouch reservoir, ileoanal anastomosis, and ileostomy for familial adenomatous polyposis (FAP) in November 1991. Postoperative histopathological findings showed a carcinoma in adenoma. The ileostomy became occluded in 5 years. The patient was doing well after a second operation. Since March 2000, simple ileus was repeated and her condition gradually deteriorated. Because ileography through the ileus tube showed ileal stenosis, we conducted laparotomy in April 28, 2000. Operative findings showed the obstruction in an anastomosis from the second operation, on which was palpated a hard tumor, and the intestine was resected assuming a benign tumor or anastomotic stricture. Histopathological diagnosis was well-differentiated adenocarcinoma. No sign of recurrence has been seen, and the woman declined additional resection or chemotherapy. FAP complicated carcinoma in the small intestine is rare, and our case even more rare because it arose in ileostomy anastomosis.

Key words
familial adenomatous polyposis, adenocarcinoma, ileostomy

Reprint requests
Makoto Yoshida Department of Surgery, Kin-i-kyo Chyu-ou Hospital 10-2 Fushiko, Higashi-ku, Sapporo, 007-8505 JAPAN

Accepted
May 1, 2002

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