Journal
COLORECTAL DISEASE
Volume 10, Issue 6, Pages 621-623Publisher
WILEY
DOI: 10.1111/j.1463-1318.2007.01402.x
Keywords
ulcerative colitis; restorative proctocolectomy; anal transitional zone; stapled ileal-pouch; anal anastomosis
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The development of adenocarcinoma in the anal transitional zone, after restorative proctocolectomy for ulcerative colitis, is rare. We report the first Asian and sixth known case. A 41-year-old Indian lady had a long standing history of ulcerative colitis. Restorative proctocolectomy and stapled ileal pouch-anal anastomosis without mucosectomy was performed. She remained asymptomatic until 3 years later when she complained of discomfort on defecation. A poorly differentiated adenocarcinoma in the anal transition zone was diagnosed and she subsequently underwent an abdomino-perineal resection. The previously reported cases in the literature are reviewed. We also discuss the suggested surveillance for high-risk patients who have undergone an ileal-anal pouch anastomosis.
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