Adenocarcinoma arising from chronic perianal crohn’s disease: a case report

Massit, H.; Edderai, M.; Saouab, Rachida; Seddik, H.; Fenni, J. El; Bourazza, Ahmed

doi:10.11604/pamj.2015.22.140.7875

Cited by 5 publications

(3 citation statements)

References 6 publications

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“…The characteristics of 52 studies reporting data from 208 patients with ARC are shown in Table 2 11,15,19,23,25,28,30,34,36–80 . Although many reports did not describe the details of each characteristic, the median survival prognosis was 2.1 ± 2.3 years in 74 patients, and advanced cancer greater than stage T3 occurred in 46/74 (62.1%) patients.…”

Section: Resultsmentioning

confidence: 99%

Intestinal cancer in patients with Crohn's disease: A systematic review and meta‐analysis

Uchino

Ikeuchi

Hata

et al. 2020

J of Gastro and Hepatol

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Background and Aim Although surveillance colonoscopy is recommended by several guidelines for Crohn's disease (CD), the evidence is insufficient to support the validity of this recommendation. Moreover, the efficacy of surveillance colonoscopy for anorectal cancer remains unclear. Therefore, we performed a systematic review of cancer in patients with CD before considering the proper surveillance methods. Methods We conducted a systematic review and meta‐analysis examining the incidence of intestinal cancer and a literature review to clarify the characteristic features of cancer in CD. We performed the systematic literature review of studies published up to May 2019. Results Overall, 7344 patients were included in eight studies. The standardized incidence ratios (95% confidence intervals) of colorectal cancer (CRC) and small bowel cancer (SBC) were 2.08 (1.43–3.02) and 22.01 (9.10–53.25), respectively. The prevalence of CRC and SBC was 57/7344 (0.77%) and 17/7344 (0.23%), respectively, during a median follow‐up of 12.55 years. Additionally, 54 studies reporting 208 anorectal cancer cases were identified. In patients with anorectal cancer, the prognosis for survival was 2.1 ± 2.3 years, and advanced cancer greater than stage T3 occurred in 46/74 patients (62.1%). Many more reports of anorectal cancer were published in Asia than in Western countries. Conclusion Although we were unable to state a recommendation for surveillance for SBC, we should perform cancer surveillance for CRC in patients with CD. However, the characteristics of cancer may differ according to geography or race. We must establish proper and effective surveillance methods that are independently suitable to detect these differences.

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Section: Resultsmentioning

confidence: 99%

Intestinal cancer in patients with Crohn's disease: A systematic review and meta‐analysis

Uchino

Ikeuchi

Hata

et al. 2020

J of Gastro and Hepatol

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“…There are three main pathological subtypes of carcinoma arising from an anal fistula—mucinous adenocarcinoma, adenocarcinoma, and squamous cell carcinoma[ 16 - 19 ]. Thomas et al[ 15 ] stated that the histology of adenocarcinoma was the most common (~59%); however, mucinous adenocarcinoma was the most common pathological type in our study (8/10).…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging findings of carcinoma arising from anal fistula: A retrospective study in a single institution

Zhu

Ye³

et al. 2020

WJCC

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BACKGROUND Magnetic resonance imaging (MRI) is currently the standard investigation for suspected perianal diseases. Carcinoma arising from anal fistula is very rare, and early diagnosis is often difficult. AIM To describe and summarize the MRI findings of carcinoma arising from anal fistula. METHODS In this retrospective study, records of ten patients diagnosed with carcinoma arising from anal fistula and confirmed by surgery ( n = 7) or biopsy ( n = 3) between June 2006 and August 2018 were analyzed. All patients underwent preoperative pelvic MRI. Morphologic features, signal characteristics, fistula between the mass and the anus, contrast enhancement of mass, signal and enhancement of peritumoral areas, and regional lymphadenopathy were assessed. RESULTS All ten tumors were solitary (8 mucinous adenocarcinomas and 2 adenocarcinomas). The maximum diameter of the tumors ranged from 3.4 cm to 12.4 cm (median: 4.15 cm; mean: 5.68 cm). Eight patients had a fistula between the mass and the anus. Contrast enhancement of the peritumoral areas was noted in three (3/5) patients. Perirectal or inguinal lymphadenopathy was noted in seven patients. Most lesions of mucinous adenocarcinoma were multiloculated and cauliflower-like, with a thin capsule and focally unclear boundary. They were markedly hyperintense on fat-suppressed T2WI, slightly hyperintense with focal hyperintensity on diffusion-weighted imaging (DWI), and hyperintense with focal hypointensity on apparent diffusion coefficient (ADC) map, with progressive mesh-like contrast enhancement. Adenocarcinomas had an infiltrative margin without a capsule and appeared heterogeneously hyperintense or slightly hyperintense on fat-suppressed T2WI, hyperintense on DWI, and hypointense on ADC map, with persistent heterogeneous enhancement. CONCLUSION Our study highlighted several characteristic and potentially helpful MRI findings to diagnose carcinomas arising from anal fistula.

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“…Das perianal-fistelassoziierte Karzinom ist ein sehr aggressiver Tumor, der gekennzeichnet ist von einer meist schwierigen und leider häufig zu späten Diagnose (29)…”

Section: Diskussionunclassified

Perianal Fistula-Associated Carcinoma in Crohn’s Disease: A Multicentre Retrospective Case Control Study

Palmieri

Müller

Kroesen

et al. 2021

Journal of Crohn's and Colitis

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Background & Aims Carcinoma associated with perianal fistula in Crohn’s disease is a pending threat for patients. This study was aimed to improve understanding and facilitate development of diagnostic and therapeutic strategies. Methods A retrospective case-control study was conducted at four German hospitals. The analysis included forty patients with proven malignancy associated with perianal Crohn’s fistulas and forty randomly-selected controls with fistulizing perianal Crohn’s disease. Differences between groups were analysed and multivariate calculations performed to describe risk factors for oncological outcomes. Results Histology revealed adenocarcinoma in 33/40 patients and squamous cell carcinoma in 7/40 patients. Compared to fistula patients without carcinoma, patients with malignancies associated to fistula had a diagnosis of Crohn’s disease in younger age. Crohn’s disease lasted longer in patients with malignancy (25.8 ± 9.0 vs. 19.6 ± 10.4; p=0.006). Fistula related findings differed significantly between both groups. Signs for complicated and severe fistulation including complex anatomy and chronic activity occurred significantly more often in patients with malignancy associated to fistula. Significant multivariate hazard ratios for overall mortality and progression-free survival were shown for histologic type of cancer, metastatic disease and R1 resection. Overall survival (OS) was 45.1±28.6 months and the 5-year survival rate was 65%. Conclusions In patients with adenocarcinoma or squamous cell carcinoma associated with perianal fistula in Crohn’s disease, fistula characteristics determine risk for malignancy. Early diagnosis influences outcomes, while treatment of chronic fistula activity may be key to preventing malignancy. Expert multimodal therapy is paramount for successful treatment of perianal fistula-associated malignancies.

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Adenocarcinoma arising from chronic perianal crohn’s disease: a case report

Cited by 5 publications

References 6 publications

Intestinal cancer in patients with Crohn's disease: A systematic review and meta‐analysis

Intestinal cancer in patients with Crohn's disease: A systematic review and meta‐analysis

Magnetic resonance imaging findings of carcinoma arising from anal fistula: A retrospective study in a single institution

Perianal Fistula-Associated Carcinoma in Crohn’s Disease: A Multicentre Retrospective Case Control Study

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