Primary adenocarcinoma arising in an ileostomy

Two cases are added to the world literature of patients in whom an adenocarcinoma developed at the ileostomy site after total proctocolectomy for ulcerative colitis. Fourteen additional cases have been reported in the world literature; of these, 12 cases have been in patients with ulcerative colitis, and four cases have been in patients with familial adenomatous polyposis. Adenocarcinoma of an ileostomy is not common. However, in the analysis of the reported cases, patients with long-standing ileostomies appear to be at a greater risk. With an aging ileostomy population, an increase in the number of cases may be seen. Three hypotheses are discussed as potential causative pathways to this entity. Continued analysis of these cases may yield information on the pathophysiology involved.