A rare occurrence of primary adenocarcinoma arising in an interposed colon
nearly seven years after the surgery is described. Remarkably, there were n
o symptoms from a large mass In the transposed bowel. Diagnosis was made fo
rtuitously while searching for the cause of the patient's iron-deficiency a
nemia. The rationale for careful preoperative screening of the colonic segm
ent intended for transplant to exclude pre-existing pathology is reemphasiz
ed. The various methods of evaluating the postoperative colon graft and the
ir advantages and limitations are discussed.