J Wound Manag Res.  2020 Jun;16(2):125-130. 10.22467/jwmr.2020.01018.

Adenocarcinoma Arising at a Urostomy: Case Report and Literature Review

• Jeon S
• Myung Y
• Pak C

• KMID: 2504102
• DOI: http://doi.org/10.22467/jwmr.2020.01018

Abstract

We report a case of adenocarcinoma originating in a urostomy site 35 years after bladder cancer operation and urostomy formation. While ileostomy adenocarcinoma has been reported as a rare complication after colectomy and ileostomy formation for inflammatory bowel disease or familial adenomatous polyposis, there were no previously published cases of parastomal carcinoma in patients with urostomy. In our case, a series of work-ups, including immunohistochemical staining (cytokeratin 7 and 20, p63), revealed no evidence of primary adenocarcinoma of the skin or any other primary tumor. The patient underwent surgical excision with urostomy reformation and the skin defect was successfully reconstructed using local flap and split-thickness skin graft. This case poses a diagnostic challenge for clinicians because skin primary adenocarcinoma (i.e., malignant adnexal tumor) is likely to be ruled out due to its low incidence, and the symptoms may be considered those of a rare subcutaneous metastasis from a visceral malignancy (e.g., colon cancer) in the patient with a history of a prior malignancy (bladder cancer). This underscores the need for a multidisciplinary approach and patient education for early diagnosis.

Keyword

Adenocarcinoma; Skin neoplasms; Surgical wound; Urinary bladder