We report a case of implantation of tumor cells within a fistula in ano. A 36-year-old man with a 16-year history of an anal fistula underwent an operation for rectal carcinoma. Three weeks later, the anal fistula was resected. A histological examination of the specimen showed atypical cells; moreover, rectal carcinoma had proliferated in the granulation tissue lying underneath the intact squamous epithelium. Because there was no continuity to the rectal carcinoma or the anal glands, we diagnosed implantation of rectal cancer cells in a fistula in ano.
DepartmentsofSurgery 1) andPathology 2) ,KyoritsuGeneralHospital Anadultcaseofintestinalobstructioncausedbyavitellinecystisreported.A28-year-oldmanpresentedtoourhospitalbecauseofcontinuousabdominalpainaroundtheumbilicus.Abdominalenhanced computedtomographyshowedmarkeddilatationofthesmallintestineandacysticlesiondirectlyunder theumbilicus.Thecystwasapproximately60mminmaximaldiameter.Thepreoperativediagnosiswas intestinalobstructioncausedbyavitellinecyst.Intraoperatively,thesmallintestinewasseentobeobstructedbyaband-likestructureextendingfromthecysttotheileumoftheoralside,95cmfromtheileocecum.Enblocresectionofthevitellinecystandtheband-likestructurewasperformed.Histological examinationofthespecimenshowedthecompletestructureoftheintestinalwallatthesiteofthevitelline cyst. Meckel's diverticulum is well known as a form of vitello-intestinal duct remnant, but other formsarerareinadults.Thiscaseispresentedalongwithareviewoftheliterature.
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