A rare case of rectal cancer with perianal metastasis: a case report

Ikeda, Takuto; Nanashima, Atsushi; Ichihara, Akiko; Kitamura, Eiji; Nagatomo, Kenzo; Tanaka, Hiroyuki

doi:10.1186/s12957-019-1692-7

Cited by 9 publications

(13 citation statements)

References 15 publications

(15 reference statements)

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“…Furthermore, a concordant immunochemistry cytokeratin 7 negative and cytokeratin 20 positive supports a common origin and helps rule out an anal gland adenocarcinoma. In general, the patients reported were treated with curative-intent surgery (in some cases with chemotherapy or chemoradiotherapy associated) and showed good prognosis, better than in cases with lymphatic or hematogenous spread (11).…”

Section: Discussionmentioning

confidence: 99%

“…Less than 30 cases of sCRC metastasis into anal fistula have been reported and they may be the first symptom of a left-sided sCRC, most frequently in patients with an advanced clinical stage (7-10). Since primary sCRC and anal metastasis are usually discovered at the same time, various attempts to differentiate synchronous from a metastatic anal tumor have been done, based on several criteria: similar histological findings, lack of dysplasia in the surrounding anal glands, lack of mucin and the absence of lymph node and vasculolymphatic invasion (11). Furthermore, a concordant immunochemistry cytokeratin 7 negative and cytokeratin 20 positive supports a common origin and helps rule out an anal gland adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

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Endoluminal tumor implant of a colorectal cancer in an anal fistula detected by FISH techniques: a case report

Montero-Mateos¹,

Carmen²,

Sanz³

et al. 2021

J Gastrointest Oncol

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Intraluminal shedding of tumor cells is a rare infrequent sporadic colorectal cancer (sCRC) mechanism of spreading. Less than 30 cases of sCRC metastasis into anal fistula have been reported. Here, we study a 72-year-old male with an adenocarcinoma arising in an anal fistula. Subsequent studies revealed another tumor in the rectum without distant metastatic disease; therefore, a curative-intent abdominoperineal resection was performed. The histologic study showed a moderately differentiated adenocarcinoma in both locations. No perineural or lymphovascular invasion was observed, and all the lymphatic nodes resected were negative for malignancy. Both tumors showed positive CK20 and negative CK7 immunostaining, but KRAS G12D mutation was only detected in the rectal tumor. After those conventional studies, a cytogenetic profile of both tumors was performed by interphase fluorescence in situ hybridization (iFISH) techniques. The FISH study displayed an identical genetic profile in both tumors, loss of the chromosomes 8 and 18q, and no alteration in chromosome 7 and 13q. Based on pathological and genetic findings, we established the same clonal origin of both tumors. Currently, the diagnosis of an intraluminal CRC metastasis relies on histologic and immunohistochemistry findings. We suggest that genetic studies at the individual cell level by FISH techniques may be useful in order to differentiate synchronous from intraluminal metastasis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endoluminal tumor implant of a colorectal cancer in an anal fistula detected by FISH techniques: a case report

Montero-Mateos¹,

Carmen²,

Sanz³

et al. 2021

J Gastrointest Oncol

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“…To the best of our knowledge, this sequence of treatment has not been reported previously. ChemoRT has been administered postoperatively or preoperatively in a few cases of synchronous anal fistula and colorectal cancer; none of those patients developed recurrences (3). Furthermore, there are no reports of treatment of such cases with RT alone (3,12).…”

Section: Discussionmentioning

confidence: 99%

Relapse of Rectal Cancer in an Anal Fistula: A Rare Case

Katō

Miyamoto

Shinmoto

et al. 2021

In Vivo

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Background: Colorectal cancer is the second most common cause of cancer-related death worldwide. It is well-known that metasta sis to the liver and lung and local recurrences can occur. Additionally, colorectal cancer occasionally metastasizes to other sites. Only a few reports of such metastases have been published and no definitive therapeutic strategies have been proposed for them. Case Report: The case of a 77-year-old man who was diagnosed with rectal cancer is presented. Eighteen months after curative laparoscopic low anterior resection and D3 lymph node resection, an anal fistula metastasis was diagnosed by computed tomography and biopsy. After administering radiotherapy, percutaneous excision of the lesion. was performed. At 21 months from the surgery, the patient is healthy and no recurrence has been found. Conclusion: Metachronous metastasis of a colorectal cancer to an anal fistula is rare. Careful investigation and optimal treatment can result in a disease-free status.Anal fistulas are known to result in abscesses; additionally, primary cancer originates in 0.1% of anal fistulas (1, 2). Metastasis of a cancer to an anal fistula is very rare. There are some reports of synchronous colorectal cancer in an anal fistula; however, metachronous colorectal cancer developing in an anal fistula has rarely been reported (3). We present a case of a patient with rectal cancer who developed a recurrence in an anal fistula and was treated successfully with radiation therapy (RT) and surgery.

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“…Ikeda [17] 68, Male The patient had computed tomography (CT) of the abdomen that revealed prominent wall thickening of the terminal ileum consistent with active in ammation suggestive of CD are with a stulous tract noted between the terminal ileum and sigmoid colon. (Figure 1)…”

Section: Discussionmentioning

confidence: 99%

Colon Adenocarcinoma Metastasis Through Ileocolic Fistula to Small Bowel in the Setting of Crohn’s Disease

Tseng

Syed

Zot

et al. 2021

Preprint

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Purpose: Patients with Crohn’s disease (CD) are at higher risk of developing colorectal cancer (CRC) and gastrointestinal fistula. We report an unusual case of sigmoid colon adenocarcinoma in a CD patient that metastasized to the small bowel through an ileocolic fistula tract.Methods: This case report was written after patient was seen in the clinic and reviewing overall hospitalization including clinically relevant data including imaging and pathology reports associated to our focus and presentation. Prior cases of metastatic CRC via fistula tract were reviewed and compared as well. Results: We described an unprecedented case of a sigmoid adenocarcinoma metastasized to ileum via ileal-sigmoid fistula. Patient received surgical treatment and systemic chemotherapy and currently in remission. Conclusion: CD is associated with a higher risk of fistula development. Few cases in the past described CRC metastasized within the gastrointestinal tract through a fistula. Intriguingly in our case, sigmoid adenocarcinoma developed and further metastasized to the ileum via the ileal-sigmoid fistula in the setting of CD. In addition to presenting a unique pathological phenomenon in these patients, this case raises awareness of the importance of regular follow-up and early initiation of IBD therapies.

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A rare case of rectal cancer with perianal metastasis: a case report

Cited by 9 publications

References 15 publications

Endoluminal tumor implant of a colorectal cancer in an anal fistula detected by FISH techniques: a case report

Endoluminal tumor implant of a colorectal cancer in an anal fistula detected by FISH techniques: a case report

Relapse of Rectal Cancer in an Anal Fistula: A Rare Case

Colon Adenocarcinoma Metastasis Through Ileocolic Fistula to Small Bowel in the Setting of Crohn’s Disease

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