<p>This case presents a rare instance of ulcerative colitis (UC) relapse in the functionally isolated left colon following surgery for rectal cancer associated with UC. A 62-year-old man, suspected of having cancer based on positron emission tomography (PET)-computed tomography (CT) findings and elevated carcinoembryonic antigen levels, underwent robot-assisted low anterior resection and temporary transverse colostomy. Postoperatively, leakage and infection made it difficult to administer conventional local treatments or corticosteroids; however, remission was achieved with the oral α4-integrin inhibitor, carotegrast methyl, allowing for stoma closure. To our knowledge, this report is the first to describe the use of carotegrast methyl for recurrent UC in a diverted colon. This case demonstrates that carotegrast methyl may serve as an effective steroid-sparing option for UC relapse in complex postoperative anatomical contexts. It also highlights the potential utility of PET-CT as an adjunctive diagnostic tool for UC-associated cancer.</p>

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A rare case of ulcerative colitis relapse in a diverted colon after rectal cancer surgery: efficacy of carotegrast methyl

  • Takanori Igarashi,
  • Kentaro Tominaga,
  • Yuichi Kojima,
  • Mai Nakamura,
  • Takafumi Tonouchi,
  • Nobutaka Takeda,
  • Tomoaki Yoshida,
  • Yuzo Kawata,
  • Akira Sakamaki,
  • Shuji Terai

摘要

This case presents a rare instance of ulcerative colitis (UC) relapse in the functionally isolated left colon following surgery for rectal cancer associated with UC. A 62-year-old man, suspected of having cancer based on positron emission tomography (PET)-computed tomography (CT) findings and elevated carcinoembryonic antigen levels, underwent robot-assisted low anterior resection and temporary transverse colostomy. Postoperatively, leakage and infection made it difficult to administer conventional local treatments or corticosteroids; however, remission was achieved with the oral α4-integrin inhibitor, carotegrast methyl, allowing for stoma closure. To our knowledge, this report is the first to describe the use of carotegrast methyl for recurrent UC in a diverted colon. This case demonstrates that carotegrast methyl may serve as an effective steroid-sparing option for UC relapse in complex postoperative anatomical contexts. It also highlights the potential utility of PET-CT as an adjunctive diagnostic tool for UC-associated cancer.