Mucinous Tumour in Ileal Pouch Post Restorative Proctocolectomy and Ileal Pouch Anal Anastomosis for Familial Adenomatous Polyposis

Abstract

We present a fifty-six years old female having surveillance gastroscopy and colonoscopy
ten years after a restorative proctocolectomy and Ileal-pouch anal anastomosis (IPAA).
This was performed for Familial Adenomatous Polyposis (FAP). The patient was found to have
unusual patchy nodular areas of abnormal mucosa in the ileal pouch and at the level of the
anastomosis.
Magnetic Resonance Imaging (MRI) was performed which showed a large fluid collection
(12x10x13 cm) within the pelvis. Histopathology from biopsy was reported as a low
grade mucinous tumour with abundant mucoid material containing scattered degenerate cellular
material and histiocytes. Computed Tomography (CT) of chest and pelvis did not reveal any
evidence of metastatic disease.
A pelvic exenteration was performed and patient underwent adjuvant radiotherapy.
Histopathology showed cystic mass 50 mm × 50 mm × 30 mm in size containing mucin of
intermediate nuclear grade with 0/18 nodes involved (Figure 1).