Anal Adenocarcinoma Can Masquerade as Chronic Anal Fistula in Asians

Annals of Coloproctology

卷:35

Faith Qi-Hui Leong¹  Ker-Kan Tan¹  Dedrick Kok Hong Chan² 

[1] Division of Colorectal Surgery, University Surgical Cluster, National University Health System, Singapore;

[2] ;

关键词: anal adenocarcinoma;    chronic inflammation;    anal fistula;    diagnosis;   

DOI  :  10.3393/ac.2018.03.15

来源: DOAJ

【 摘 要 】

Purpose Perianal adenocarcinoma arising from a chronic anorectal fistula is a rare condition for which the natural history and optimal management are not well established. For that reason, we conducted a retrospective analysis of 5 consecutive patients with a perianal adenocarcinoma arising from a chronic anorectal fistula managed at our institution from January 2014 to December 2015. Methods The patients were identified from a prospectively collected colorectal cancer database that included all patients managed for colorectal cancer at our institution. Results The median age at diagnosis was 64 years (range, 55–72 years). Magnetic resonance imaging (MRI) was the initial investigation for all patients and showed a hyperintense T2-weighted image. One patient underwent an abdominoperineal resection following neoadjuvant chemoradiotherapy and remained disease free during the 12-month follow-up. Three patients received neoadjuvant therapy with intent for surgery, but did not undergo surgery due to either worsening health or metastatic spread. One patient declined intervention. The median overall survival was 10.5 months (range, 2–19 months). Conclusion A high index of suspicion is required to make a clinical diagnosis of an anal adenocarcinoma arising from a chronic fistula. Histologic diagnosis must be achieved to confirm the diagnosis. Multimodal therapy with neoadjuvant chemoradiotherapy followed by abdominoperineal resection is the treatment of choice.

【 授权许可】

Unknown