von Herbay A, Stern J, Herfarth C
Institute of Pathology, University of Heidelberg, Germany.
Am J Surg Pathol. 1996 Aug;20(8):995-9. doi: 10.1097/00000478-199608000-00008.
Familial adenomatous polyposis (FAP) and idiopathic ulcerative colitis are both mucosal diseases that bear a significant risk of developing colorectal cancer. As a consequence, their surgical treatment is currently widely performed by restorative proctocolectomy with pelvic ileal pouch-anal anastomosis (IPAA). Herein we report a new case of cancer after IPAA that developed in a 33-year-old woman with FAP. Pouch-anal cancer was diagnosed 8 years after restorative proctocolectomy, including anorectal mucosectomy, for FAP with manifest cancer in the sigmoid colon. This case observation reemphasizes that the risk of cancer for FAP patients persists as long as any rectal mucosa remains after IPAA surgery.
家族性腺瘤性息肉病（FAP）和特发性溃疡性结肠炎都是具有发生结直肠癌重大风险的黏膜疾病。因此，目前它们的外科治疗广泛采用保留盆腔回肠贮袋肛管吻合术（IPAA）的结直肠切除重建术。在此，我们报告一例IPAA术后发生癌症的新病例，该病例发生在一名患有FAP的33岁女性身上。该患者因乙状结肠明显癌变接受了包括肛门直肠黏膜切除术在内的结直肠切除重建术，术后8年被诊断为贮袋肛管癌。该病例观察再次强调，对于FAP患者而言，只要IPAA手术后仍残留任何直肠黏膜，癌症风险就依然存在。
