Synchronous mucinous adenocarcinoma of the rectosigmoid seeding onto a pre-existing anal fistulaReportar como inadecuado

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International Seminars in Surgical Oncology

, 3:25

First Online: 08 September 2006Received: 11 May 2006Accepted: 08 September 2006


Carcinoma within a long-standing fistula-in-ano is rare and may be defined by specific neoplastic involvement of the fistulous track in the absence of rectal mucosal carcinoma. The presence of a carcinoma of mucinous histology occurring synchronously in the perianal region and the colon is exceptionally rare. We present a case with a review of the literature concerning its aetiopathogenesis and treatment. A 72-year-old man with a 2 months history of dark red rectal bleeding and mucus per rectum with alternating constipation and diarrhoea, was observed. Clinical examination and a barium enema showed a perianal fistula and an annular stenosing lesion of the rectosigmoid. Preoperative CT scan confirmed the colonic lesion. Colonic resection and wide fistula excision were performed. Histology showed an adenocarcinoma with a clear resection margins. The fistula also showed a similar histology. Chemoradiation 5-Fluorouracil 425 mg-m and Leucovorin 20 mg-m with 4500 cGy external beam radiotherapy was utilized. Subsequent clinical follow-up and CT examination of the patient has not revealed recurrent disease at 14 months.

Electronic supplementary materialThe online version of this article doi:10.1186-1477-7800-3-25 contains supplementary material, which is available to authorized users.

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Autor: Nemandra Sandiford - Patsy R Prussia - Antonio Chiappa - Andrew P Zbar


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