An adenocarcinoma arising in the ileal pouch after total proctocolectomy with ileal pouch-anal anastomosis for familial adenomatous polyposis

Yoshifumi Hashimoto, Masato Nakano, Hitoshi Kameyama, Saki Yamada, Ryoma Yagi, Yosuke Tajima, Takuma Okamura, Mae Nakano, Yoshifumi Shimada, Toshifumi Wakai

Research output: Contribution to journalArticle

Abstract

We report the case of a 45-year-old man, who at the age of 24 had total proctocolectomy with ileal W-pouch anal anastomosis for familial adenomatous polyposis. A follow-up transanal endoscopy performed at the age of 38 revealed approximately 30 polyps in the ileal pouch, which were then confirmed by biopsy to be tubular adenomas. A transanal endoscopy performed at the age of 44 revealed an 8 mm 0-Is lesion located approximately 1 cm proximal to the ileal pouch-anal anastomosis, which was then removed by EMR. Histopathological analysis showed the presence of well-differentiated tubular adenocarcinoma in adenoma. To date, no recurrence of adenocarcinoma has been confirmed in follow-up transanal endoscopies. We have experienced treating a case of adenocarcinoma arising in the ileal pouch through the adenoma-carcinoma sequence after total proctocolectomy with ileal pouch-anal anastomosis for familial adenomatous polyposis. For early diagnosis and prompt treatment, it is important to perform periodic surveillance of the ileal pouch and conduct aggressive endoscopic resection when a large adenoma exceeding 10 mm is found.

Original languageEnglish
Pages (from-to)469-475
Number of pages7
JournalJapanese Journal of Gastroenterological Surgery
Volume50
Issue number6
DOIs
Publication statusPublished - 01-01-2017
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Gastroenterology

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  • Cite this

    Hashimoto, Y., Nakano, M., Kameyama, H., Yamada, S., Yagi, R., Tajima, Y., Okamura, T., Nakano, M., Shimada, Y., & Wakai, T. (2017). An adenocarcinoma arising in the ileal pouch after total proctocolectomy with ileal pouch-anal anastomosis for familial adenomatous polyposis. Japanese Journal of Gastroenterological Surgery, 50(6), 469-475. https://doi.org/10.5833/jjgs.2016.0055