Metachronous adenocarcinoma occurring at a colostomy site after abdominoperineal resection for rectal carcinoma

Carcinomas rarely occur at the site of a colostomy. A 73-year-old man underwent abdominoperineal resection (Miles' surgical procedure) for rectal carcinoma in September 1988. He did not return to the hospital until September 1995, when he was admitted with stricture of the stoma. Neither tumor nor ulcer was detected at the stoma. The tip of the doctor's little finger was able to pass through the stoma, and manual expanding alleviated the stricture. The patient did not return to the hospital again until August 1996, at age 81 years, when he visited the hospital because of complete stricture of the stoma. A biopsy revealed an adenomatous carcinoma, but the results of various examinations suggested no metastasis. A portion of the intestine, including the stoma and surrounding skin, was resected, and a new stoma was created in the descending colon. We report this rare carcinoma occurring at the site of a colostomy, and we review the literature.