Anal adenosquamous carcinoma on perineal fistula: A case report

Abstract

Introduction: Adenosquamous Carcinoma (ASC) of the anus presenting both glandular and squamous histopathologic features is a rare colorectal neoplasm. Case presentation: A 63-year-old man presented with a one-year history of intermittent rectal pain and bleeding on a perineal fistula. Pathological analysis of the surgical specimen revealed adenosquamous carcinoma of the anus, The patient received neoadjuvant treatment with chemotherapy and radiotherapy over a period of five weeks. then he underwent abdominoperineal resection and a permanent colostomy. Histology revealed invasive adenosquamous carcinoma on the resection specimen and the patient was started on adjuvant therapy with FOLFIRINOX. Discussion: Primary ASC of the colon and rectum are extremely rare clinical entities with poor prognosis. Most of the data come from individual case reports and a few small series, making it a challenge to understand the histogenesis of the disease. And the treatment modalities are not yet well codified, which has an impact on overall survival. Conclusion: Early diagnosis and radical surgery with other available therapeutic modalities can improve clinical outcomes.