The presence of adenocarcinoma of the right colon and polyp in colonic graft in a female patient with colon interposition due to caustic stricture of the esophagus in childhood

Abstract

Introduction. Colon interposition is considered an effective option for esophageal replacement in children, particularly in cases of caustic esophageal stricture. The use of colonic tissue grafts for esophageal replacement can lead to late complications, including the development of precancerous lesions and malignant tumors. The aim of the paper is to describe a female patient who was diagnosed with adenocarcinoma of the right colon at the age of 71, sixty years after surgery for benign oesophageal stricture. Case outline. A 71-year-old female presented to our clinic in January 2023 with symptoms of abdominal pain. At the age of 11, the patient had bypass esophagocoloplasty with retrosternal esophagogastrocolonic anastomosis due to oesophageal stricture after accidental caustic ingestion. CT imaging revealed tumor of the ascending colon, estimated stage T4aN1M0. An upper digestive endoscopic examination revealed one polyp while a lower digestive endoscopic examination confirmed the presence of a stenotic tumor in the ascending colon. Furthermore, a polypoid alteration was identified in the descending colon. CT angiography revealed that the tumor was found to receive its vascular supply through the middle colic artery (MCA), while the colonic transplant received its vascular supply through the right colic artery (RCA). Conclusion. It is recommended to implement lifelong endoscopic surveillance for patients who have undergone colon interposition. In cases such as this, it is crucial to establish a comprehensive treatment plan and employ effective diagnostic measures to ensure the preservation of the integrity and vascularization of the colonic graft.