Figure 1

A fungating growth visible at a stoma. This fungating growth at an end ileostomy was created 31 years ago, after a panproctocolectomy for familial adenomatous polyposis (FAP). An en bloc resection of the stoma showed an invasive and moderately differentiated adenocarcinoma arising in a severely dysplastic tubulovillous adenoma with foci of high-grade dysplasia at the mucocutaneous border.