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Morada AO, Senapathi SH, Bashiri A, Chai S, Cagir B. A systematic review of primary ileostomy site malignancies. Surg Endosc 2022; 36:1750-1760. [PMID: 34997348 DOI: 10.1007/s00464-021-08847-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 10/21/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND This paper aimed to elucidate the etiologies of all primary ileostomy site malignancies published in the literature. METHODS A review of the literature was conducted following PRISMA guidelines by querying PubMed, Global Health, and Web of Science for articles published before November 2020. Search criteria contained broad terminology for ileostomy site neoplasms without language, date, or publication limitations. A full-text review of the abstracts confirmed primary malignant pathologies and was evaluated for study inclusion. RESULTS Literature search discovered 858 publications, with 76 meeting eligibility criteria. The final sample contained 91 patients, with equal males and females. The mean age of patients with ileostomy site malignancy was 62.0 ± 12.2, with an average ileostomy age of 29.4 ± 12.4. The most common indications for ileostomy creation were inflammatory bowel disease (IBD) (73.6%) and familial adenomatous polyposis (FAP) (20.9%). There was a total of eight ileostomy malignant pathologies reported, with adenocarcinoma being the most common (76.9%), followed by squamous cell carcinoma (SCC) (11.0%). Adenocarcinoma was diagnosed at a younger age than SCC (59.7 vs. 72.3) and developed over a shorter time (28.8 vs. 37.0). Patients with FAP almost exclusively developed adenocarcinoma (94.4%) at a younger stoma age (25.8 vs. 31.4) than those with IBD who developed seven diverse pathologies. With a median follow-up of 0.75 years, four patients developed disease recurrence and received oncologic resection of their cancer less often than the 55 negative patients (p = 0.04). CONCLUSION Ileostomy site malignancies are late-appearing complications that require curative surgery. Their presentation is associated with ileostomy duration and creation indication, such as FAP or IBD. We recommend screening at a stoma age ≥ 20 or patient age ≥ 50 for patients with FAP, while stoma age ≥ 25 or patient age ≥ 60 for IBD patients.
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Affiliation(s)
- Anthony Onde Morada
- Guthrie Robert Packer Hospital, Sayre, PA, USA.,Geisinger Commonwealth School of Medicine, Scranton, PA, USA
| | | | | | | | - Burt Cagir
- Guthrie Robert Packer Hospital, Sayre, PA, USA. .,Department of Surgery, Guthrie Robert Packer Hospital, 1 Guthrie Square, Sayre, PA, 18840, USA.
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Nagai T, Okamura T, Katayama K, Chaya R, Tanaka Y, Kobayashi D, Kobayashi T, Akita H, Yasui T. Primary diffuse large B-cell lymphoma of the ileal conduit created after radical cystectomy. IJU Case Rep 2018; 1:22-24. [PMID: 32743358 PMCID: PMC7292145 DOI: 10.1002/iju5.12022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 09/13/2018] [Indexed: 11/19/2022] Open
Abstract
Introduction Creation of an ileal conduit is associated with complications. A few cases have been reported on tumor development in an ileal conduit; diffuse large B‐cell lymphoma originating from an ileal conduit is extremely rare. Case presentation A 62‐year‐old Japanese man who had undergone radical cystectomy and ileal conduit diversion 6 years previously presented with a whitish bulge that had developed on the surface of the ileal conduit during follow‐up visit. Mass biopsy was performed and the histological diagnosis was diffuse large B‐cell lymphoma. Positron emission tomography showed no metastatic lesions. We attempted chemotherapy because the tumor cells tested positive for CD20; after six courses of a regimen involving rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone; diffuse large B‐cell lymphoma of the ileal conduit resolved gradually. The patient is alive and remains free from the diagnosed diffuse large B‐cell lymphoma. Conclusion We reported an extremely rare case of diffuse large B‐cell lymphoma originating from the ileal conduit created after radical cystectomy.
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Affiliation(s)
- Takashi Nagai
- Department of Urology Anjo Kosei Hospital Anjo Japan
| | | | | | - Ryosuke Chaya
- Department of Urology Anjo Kosei Hospital Anjo Japan
| | - Yutaro Tanaka
- Department of Urology Anjo Kosei Hospital Anjo Japan.,Department of Nephro-Urology Graduate School of Medical Sciences Nagoya City University Nagoya Japan
| | | | | | | | - Takahiro Yasui
- Department of Nephro-Urology Graduate School of Medical Sciences Nagoya City University Nagoya Japan
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Toh JWT, Shedden K, Pathma-Nathan N, Ctercteko G, El Khoury T, Gaveghan F. A rare case of peristomal cutaneous B cell lymphoma. Int J Colorectal Dis 2017; 32:1365-1366. [PMID: 28710610 DOI: 10.1007/s00384-017-2841-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/12/2017] [Indexed: 02/04/2023]
Affiliation(s)
- James W T Toh
- Division of Colorectal Surgery, Department of Surgery, Westmead Hospital, University of Sydney Westmead Clinical School, Sydney, NSW, Australia.
| | - Karen Shedden
- Division of Colorectal Surgery, Department of Surgery, Westmead Hospital, University of Sydney Westmead Clinical School, Sydney, NSW, Australia
| | - Nimalan Pathma-Nathan
- Division of Colorectal Surgery, Department of Surgery, Westmead Hospital, University of Sydney Westmead Clinical School, Sydney, NSW, Australia
| | - Grahame Ctercteko
- Division of Colorectal Surgery, Department of Surgery, Westmead Hospital, University of Sydney Westmead Clinical School, Sydney, NSW, Australia
| | - Toufic El Khoury
- Division of Colorectal Surgery, Department of Surgery, Westmead Hospital, University of Sydney Westmead Clinical School, Sydney, NSW, Australia
| | - Fiona Gaveghan
- Division of Colorectal Surgery, Department of Surgery, Westmead Hospital, University of Sydney Westmead Clinical School, Sydney, NSW, Australia
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Ota S, Iwai T, Kawaji Y, Fujino T, Ohshiro M, Hirakawa Y, Chinen Y, Uchiyama H, Kaneko H, Kuroda J. A treatment refractory CD30-positive diffuse large B cell lymphoma in the ileal neobladder. Ann Hematol 2016; 96:683-684. [PMID: 28032185 DOI: 10.1007/s00277-016-2908-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Accepted: 12/17/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Saeko Ota
- Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.,Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Toshiki Iwai
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Yuka Kawaji
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Takahiro Fujino
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Muneo Ohshiro
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Yoshiko Hirakawa
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Yoshiaki Chinen
- Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Hitoji Uchiyama
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Hiroto Kaneko
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan.,Department of Hematology, Aiseikai Yamashina Hospital, Kyoto, Japan
| | - Junya Kuroda
- Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
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Muta T, Nakaike T, Fujisaki T, Shiraishi T, Ohshima K. Diffuse large B-cell lymphoma arising primarily at the stoma after bladder reconstruction using ileal conduit. Intern Med 2012; 51:643-6. [PMID: 22449676 DOI: 10.2169/internalmedicine.51.6851] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 76-year-old man suffered from swelling stoma for several weeks. A biopsy sample revealed the diffuse infiltration of large lymphoid cells which were positive for CD20, bcl-6, and MUM1. The patient was diagnosed with diffuse large B-cell lymphoma, with a non-germinal center B-cell pattern. A whole-body PET-CT scan revealed that the lymphoma was restricted to the stomal site. Bladder reconstruction was undertaken using the ileal conduit: this is the first reported case of lymphoma that developed primarily at the stoma. During the long-term maintenance after bladder reconstruction, clinicians should consider the possibility of lymphoma at the stomal site.
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MESH Headings
- Aged
- Antigens, CD20/analysis
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/analysis
- Carcinoma, Transitional Cell/surgery
- Cyclophosphamide/administration & dosage
- DNA-Binding Proteins/analysis
- Doxorubicin/administration & dosage
- Doxorubicin/analogs & derivatives
- Humans
- Interferon Regulatory Factors/analysis
- Lymphoma, Large B-Cell, Diffuse/chemistry
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/etiology
- Male
- Neoplasms, Second Primary/chemistry
- Neoplasms, Second Primary/etiology
- Postoperative Complications/drug therapy
- Postoperative Complications/etiology
- Prednisolone/administration & dosage
- Proto-Oncogene Proteins c-bcl-6
- Remission Induction
- Surgical Stomas/pathology
- Urinary Bladder Neoplasms/surgery
- Urinary Diversion
- Vincristine/administration & dosage
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Affiliation(s)
- Tsuyoshi Muta
- Department of Internal Medicine, Chihaya Hospital, Japan.
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Gambiez L, Cosnes J, Guedon C, Karoui M, Sielezneff I, Zerbib P, Panis Y. [Post operative care]. ACTA ACUST UNITED AC 2005; 28:1005-30. [PMID: 15672572 DOI: 10.1016/s0399-8320(04)95178-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Luc Gambiez
- Service de chirurgie digestive et transplantation, Hôpital Claude Huriez, 59034 Lille
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Bruun JS, Rorabaugh JD. Cutaneous T-cell lymphoma associated with ileostomy: Management of uncommon stomal complication. ACTA ACUST UNITED AC 2002; 59:86-90. [PMID: 16093112 DOI: 10.1016/s0149-7944(01)00609-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE Cutaneous T-cell lymphoma involvement of an ileostomy is a rare stomal complication. METHODS We present the case of a 54-year-old man who presented with peristomal skin breakdown associated with fevers and chills. RESULTS The stoma was taken down, and the surrounding skin debrided. A new ileostomy was created in left abdominal wall. Pathology specimens of the debrided skin, subcutaneous tissue, and stoma returned positive for cutaneous T-cell lymphoma. CONCLUSIONS The medical treatment of the underlying T-cell lymphoma can give a good diagnosis when it is diagnosed early, but late-stage identification is less encouraging. The surgical treatment involves debridement and careful planning for ileostomy formation.
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Affiliation(s)
- John S Bruun
- Department of Surgery, David Grant Medical Center, Travis Air Force Base, California, USA
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Seo IS, Henley JD, Min KW, Yum MN. True histiocytic lymphoma of the esophagus in an HIV-positive patient: an ultrastructural study. Ultrastruct Pathol 1999; 23:333-9. [PMID: 10582271 DOI: 10.1080/019131299281482] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
A 56-year-old white woman, seropositive for human immunodeficiency virus for 18 months without signs of acquired immunodeficiency syndrome, presented with retrosternal pain and progressive dysphagia secondary to an exophytic esophageal mass. Biopsies of the tumor showed a malignant neoplasm composed of pleomorphic, noncohesive cells growing in a diffuse, sheet-like fashion. Immunohistochemically, tumor cells were nonreactive with epithelial, lymphoid, neural, and monocyte/macrophage markers. Despite the noncontributory immunohistochemical findings, ultrastructural study of the tumor cells revealed convincing histiocytic features. Individual cells possessed long, slender filopodial projections, prominent Golgi apparatus, residual bodies, rare lysosomes, and prelysosomes. Immunoglobulin heavy chain and T-cell receptor gamma gene rearrangement studies detected no evidence of a clonal gene rearrangement. The patient responded poorly to chemotherapy and died 5 months after her initial symptom of dysphagia.
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MESH Headings
- Antineoplastic Agents/therapeutic use
- Biomarkers, Tumor/analysis
- Esophageal Neoplasms/chemistry
- Esophageal Neoplasms/drug therapy
- Esophageal Neoplasms/ultrastructure
- Fatal Outcome
- Female
- HIV Infections/drug therapy
- HIV Infections/pathology
- HIV Seropositivity
- Humans
- Immunocompromised Host
- Immunoenzyme Techniques
- Lymphoma, AIDS-Related/chemistry
- Lymphoma, AIDS-Related/ultrastructure
- Lymphoma, Large B-Cell, Diffuse/chemistry
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/ultrastructure
- Microscopy, Electron
- Middle Aged
- Tomography, X-Ray Computed
- Zidovudine/therapeutic use
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Affiliation(s)
- I S Seo
- Department of Pathology, Wishard Memorial Hospital-Indiana University Medical Center, Indianapolis 46202, USA
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Abstract
Primary GI lymphoma is a rare clinical entity. A primary nodal tumor should be ruled out. Symptoms may not be localizing and B symptoms are less common. A tissue diagnosis, preferably by transmural biopsy for small intestinal involvement, often reveals a high-grade morphology. The staging work-up should include a bone marrow examination, although formal staging laparatomy is not always required. Patients with Mushoff stage IE or IIE1 disease do better than those with extraregional nodal disease or distant metastatic involvement. Surgical resection with clear margins is required in order to maximize the changes for cure. Chemotherapy or radiotherapy may give a survival advantage when used as adjuvant treatment for selected stage IE and IIE disease. Chemotherapy should be used after surgical debulking in more advanced disease in order to minimize the chance for bleeding or performation. Future randomized, multi-institutional trials will give more direction as to the best modes of management.
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Affiliation(s)
- C R Thomas
- Department of Internal Medicine, Rush Medical College, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612
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