Which statement about peristomal carcinomas is true?

• A. Ileostomies are associated with adenocarcinomas
• B. Carcinomas do not occur in peristomal tissue
• C. Peristomal cancer is fully understood in etiology
• D. All ostomies develop cancer at site

Answer: (A)

Peristomal cancers arise when malignant changes develop in the tissue around the ostomy. In ileostomies, the stoma brings ileal mucosa to the skin, and that glandular epithelium can undergo malignant transformation, most commonly presenting as adenocarcinoma. Chronic irritation from ostomy effluent and long-standing use of the stoma can contribute to dysplastic changes over time, making adenocarcinoma a plausible association with ileostomies.

Carcinomas in the peristomal area do occur, so stating they do not would be inaccurate. The etiology of peristomal cancer is not completely understood; while irritation and inflammation are important factors, there isn’t a single established cause. Cancer at the ostomy site is not universal—it's relatively rare, so it isn’t correct to say all ostomies will develop cancer at the site.