Fig. 3.

3A, Macroscopic picture of proctectomy in a 29-year-old man who underwent ileorectal anastomosis 10 years earlier. The mucosa surface was affected by a diffuse polyposis without areas free of neoplastic growth. The mucosectomy specimen is continuous, and the submucosal dissection plane defines the completeness of its removal from the anal transitional zone area. No carcinoma was found in the rectum, but there was 1 adenoma with high-grade dysplasia.

3B and 3C, Four years later, the patient underwent pouch excision and definitive ileostomy; the ileal pouch mucosa presented a right lateral elevated mass of 2 cm over a firm basis, located 4 cm from the anal margin and extending cranially for 2 cm. Histological analysis showed an advanced mucinous adenocarcinoma (T3, N0). Reproduced with permission of the publisher: Tonelli et al., Dis Colon Rectum 2012;55:322–329.¹⁷