PET/CT in recognition of a complicated case of adenocarcinoma within ileal pouch-anal anastomosis in a patient after restorative proctocolectomy for familial adenomatous polyposis

Abstract

Background: The authors present a patient who developed adenocarcinoma within the ileal "J" pouch-anal anastomosis (IPAA) after restorative proctocolectomy for familial adenomatous polyposis (FAP). Case report: The patient was treated for recurrent adenomatous polyps within the ileoanal anastomosis. Regular examination of the patient with endoscopic, histopathological and radiological measures such as ultrasonography (USG), computed tomography (CT) and magnetic resonance imaging (MRI) did not reveal malignant transformation in recurrent adenomatous polyps. Only positron emission tomography/computed tomography (PET/CT) showed a suspicious lesion. As a result abdominoperineal excision of the ileal pouch and anal canal was performed and diagnosis of cancer was confirmed on histopathological assessment. Conclusion: In our opinion PET/CT is recommended in each case of dysplasia in patients operated on for FAP.