Rectal Carcinoma Associated with Ileal Mesenteric Lymph Node Metastasis following Ileorectal Anastomosis and Total Colectomy for Familial Adenomatous Polyposis

Nobuyasu Takahashi, Sei-ichiro Jimi, Masayuki Hotokezaka, Sayaka Moriguchi* and Kazuo Chijiiwa

Department of Surgery 1 and Department of Pathology*, Miyazaki University School of Medicine

A 48-year-old man was admitted to our hospital for melena. He had a history of familial adenomatous polyposis and had undergone total colectomy with ileorectal anastomosis (IRA) for ascending colon cancer (mucinous adenocarcinoma, stage IIIb) 17 years previously. A few polyps in the residual rectum had been removed at that time, and the patient had been followed up for 1 year, but failed to return for further examination. After admission to our hospital abdominoperineal resection was performed to treat the numerous polyps in the residual rectum. Two advanced cancers were found in the resected specimen, and histologic examination revealed lymph node metastasis in the ρ-shaped ileal mesentery. It is important to be aware of the possibility of lymph node metastasis in the ileal mesentery of patients with carcinoma in the residual rectum after total colectomy with IRA.

Key words
familial adenomatous polyposis, ileorectal anastomosis, lymph nodes dissection

Reprint requests
Kazuo Chijiiwa Department of Surgery 1, Miyazaki University School of Medicine
5200 Kihara, Kiyotake, Miyazaki, 889-1692 JAPAN

Accepted
April 26, 2006

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