A Case of Ulcerative Colitis with Anastomotic Recurrence after Ileal Pouch Anal Anastomosis for Early Stage Cancer of the Rectoanal Canal

A 57-year-old man was diagnosed with ulcerative colitis at the age of 27. In August 2016, colonoscopy revealed an elevated lesion in the lower rectum, which was diagnosed as colitis-associated rectal cancer by pathological examination. In October of the same year, the patient underwent total proctocolectomy with ileal J-pouch anal anastomosis and ileostomy. The pathological results were pT1b, pN0, pM0, pStage I. In May 2020, pouchoscopy showed a mass lesion in the 5 to 6-o’clock direction of the previous anastomosis, which was diagnosed as adenocarcinoma by biopsy. The patient underwent resection of ileal J-pouch in June 2020. The final pathological diagnosis was rT1b, N0, M0, Stage I and the histological findings were similar to those for the previous specimen, which was consistent with recurrence. We report this case as a rare example of anastomotic recurrence after total proctocolectomy and ileoanal anastomosis.