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CASE REPORT
Cancer arising from the remnant mucosa of the ileoanal anastomosis leading to pouchectomy
  1. Leon Gearoid Walsh1,2,
  2. Bryan J Kenny3,
  3. Mazen El Bassiouni4,
  4. John Calvin Coffey1,2,5
  1. 1Department of Surgery, University Hospital Limerick, Limerick, Limerick, Ireland
  2. 2Department of Surgery, University of Limerick GEMS, Limerick, Limerick, Ireland
  3. 3Department of Radiology, University Hospital Limerick, Limerick, Limerick, Ireland
  4. 4Cancer Centre, University Hospital Limerick, Limerick, Limerick, Ireland
  5. 5Centre for Interventions in Infection, Inflammation and Immunity, Graduate Entry Medical School, University of Limerick, Limerick, Ireland
  1. Correspondence to Dr Leon Gearoid Walsh, leongwalsh{at}icloud.com

Summary

Ileal pouch-related adenocarcinoma remains a rarity; thus, guidelines on treatment are currently lacking. We present this case of a 54-year-old man who underwent restorative proctocolectomy with stapled ileal pouch–anal anastomosis formation for familial adenomatous polyposis during the 1980s. Despite undergoing annual surveillance endoscopy, the patient was noted to be anaemic and passing fresh blood per anus. Endoscopy and radiological investigation revealed the presence of a pouch-related adenocarcinoma. This was subsequently treated with short-course radiotherapy and pouch excision. The patient remains well until now and will follow six-monthly surveillance protocols with a transition to annual surveillance after 2 years.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bcr-2015-212802

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