A CASE REPORT OF SQUAMOUS CELL CARCINOMA AT THE COLOSTOMY SITE

Abstract

Tumor at the intestinal stoma site has been reported as one of the late complications of stomas. There have been very few reports about malignant tumors except adenocarcinomas originating from the colostomy site after abdominal-perineal resection for rectal cancer, and the ileostomy site after total colectomy for familial polyposis coli (FAP) or ulcertive colitis (UC).
We present here an interesting case of squamous cell carcinoma at the colostomy site. The patient was a 58-year-old woman on hemodialysis chronically. She had been colostomised for atresia ani on the 21 st day after birth and colostomy had been reconstructioned because of ileus when she was 26 years old.
Recently, granulation tissues were growing around her stoma site and she had been treated with electrocoagulation. After she was transferred to the hospital, a peristomal polypoid tumor appeared and grew to golfball size in about 10 months. Though we could not prove it malignant by a biopsy, the polypoid tumor easily bled and disturbed to use colostomy pouching systems. So it was resected under epidural anesthesia. Pathological diagnosis of the excised material was well differentiated squamous cell carcinoma. We speculated that the high carcinogenesis in the hemodialyzed patients and chronic irritation to the skin around the colostomy might participate in development of the tumor.