<Case Report>A case with localized ileal amyloidosis observed 10 years after radiation therapy

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A 79-year-old female developed massive melena during laser treatment for early gastric cancer (IIa). Based on a detailed examination, hemorrhage from the ileum was suspected. The patient underwent laparotomy when her general condition had improved. An ileal stricture, observed over an area ranging from 20 cm to 25 cm in the oral direction from the ileal end, was resected. The patient's condition was initially considered to be due to the delayed effects of radiogenic enteritis. This assumption was based on her past history of irradiation for cancer of the uterine cervix about 10 years prior to the onset of the present illness. The site of the ileal lesion coincided with that of the previous irradiation. Since Congo red staining of the vascular walls in the ileal lesion was positive after pretreatment of the histological specimen with permanganic acid, the patient was diagnosed as suffering from AL type amyloidosis. Since no amyloid deposits were evident before or after laser treatment of the stomach, or in biopsy tissue from the large intestine, the patient's condition was diagnosed as locauized ileal amyloidosis which is thought to have developed after irradiation. Massive melena in this case as the initial presentation of localized ileal of localized ileal amyloidosis is rare in the literature.
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