Can carcinomas occur in the peristomal region, and if so, what is associated with ileostomies?

• A. Peristomal cancers are exclusive to urostomies
• B. Peristomal cancers are common in all ostomies due to skin contact
• C. Cancer development is due to bacterial infection
• D. Ileostomies are associated with adenocarcinomas

Answer: (D)

The idea here is that tissue at the stoma can undergo malignant change, especially when a stoma has been present for a long time. In ileostomies, the exposed mucosa is intestinal (ileal) mucosa, which is glandular. Over years of irritation and inflammatory changes at the mucocutaneous junction, this ileal mucosa can rarely transform into cancer, and when it does, the cancer is typically an adenocarcinoma (a cancer of glandular origin). So, the statement that ileostomies are associated with adenocarcinomas reflects this possibility.

The other options aren’t correct because peristomal cancers are not restricted to urostomies, aren’t common across all ostomies simply due to skin contact, and aren’t caused merely by bacterial infection.