Adenocarcinoma of the Sigmoid Colon Seeding a Chronic Anal Fistula

Abstract

Damaged mucosal sites seem to be vulnerable to tumor cell implantation. We describe a case of exfoliated tumor cells from a sigmoid colon cancer seeding a long-standing anal fistula. The implications of this finding are reviewed.

Endoscopic excision of synchronous large bowel polyps in the presence of colorectal carcinoma: is the fear of malignant cell implantation justified? A systematic review of the literature

“…Notable mammalian studies by Yu and Cohn , Broyn and Hubens et al . have been heavily referenced in modern publications as providing ‘strong support for the concept of tumour cell implantation in mucosal sites that have been altered or denuded by a variety of factors’ . Having reviewed the original articles, the authors of the present review feel the scientific results of these papers may have been misinterpreted.…”

“…Little attention, however, has been given to quantifying the risk of tumour cell seeding during endoscopic procedures of the large bowel. Notable mammalian studies by Yu and Cohn [73], Broyn [74] and Hubens et al [75] have been heavily referenced in modern publications as providing 'strong support for the concept of tumour cell implantation in mucosal sites that have been altered or denuded by a variety of factors' [37]. Having reviewed the original articles, the authors of the present review feel the scientific results of [73] in 1968 demonstrated no evidence of implantation of cancer cells into normal or damaged colonic mucosa.…”

“…These have a well‐recognized role in anastomotic recurrence , suture line implantation and seeding onto stapling devices . Rarely, colorectal adenocarcinoma cells can implant into the tracks of a fistula‐in‐ano (Table ), haemorrhoidectomy scars and other miscellaneous sites of anal trauma .…”

Anal metastasis of rectal cancer—adenocarcinoma of squamous cells: a case report and literature review

“…Several reports have indicated that immunohistochemical analysis is critical for confirming a diagnosis of anal metastasis of rectal carcinoma [3, 5–7]. Cytokeratin (CK) is an epithelial protein, so determination of its presence is helpful for establishing the origin of metastatic carcinoma [8].…”

Rectosigmoid adenocarcinoma revealed by metastatic anal fistula. The visible part of the iceberg: a report of two cases with literature review

“…Histological differentiation and immunohistochemical staining must show the same characteristic in both tumors. More specifically, immunohistochemistry of CK7 and CK20 remains the examination of choice to distinguish between colonic tumor tissues and tumors originating from the anal glands [16]. Ramalingam et al have previously described that anal glands were strongly immunoreactive to antibodies against CK7 but not to CK20 [28].…”