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Ileostomy adenocarcinoma in Crohn's disease.

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.

journal_name

Int J Colorectal Dis

journal_title

International journal of colorectal disease

authors

Yousaf A,Beatty C,Zinn Z,Cassim R,Gayam S

doi

10.1007/s00384-020-03554-6

subject

Has Abstract

pub_date

2020-05-01 00:00:00

pages

963-966

issue

5

eissn

0179-1958

issn

1432-1262

pii

10.1007/s00384-020-03554-6

journal_volume

35

pub_type

杂志文章

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