Clinicopathological Characteristics and Clinical Outcomes of Anal Fistula Cancer in 42 Patients

Sassa, Motoki; Yamana, Tetsuo; Ono, Tomojiro; Nishio, Risa; Okada, Daisuke; Furukawa, Satomi; Okamoto, Kinya; Sahara, Rikisaburo

doi:10.3862/jcoloproctology.70.57

Cited by 3 publications

(5 citation statements)

References 2 publications

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“…In our patient, the fistula had been present for 4 years and there was no tumor present in the rectal mucosa. The authors of other studies in the literature have reported a varied time period between the onset of a fistula and its presentation as a malignant lesion (Table 1) [4][5][6][7][8][9][10][11].…”

Section: Discussionmentioning

confidence: 99%

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Chronic fistula in ano associated with adenocarcinoma: a case report with a review of the literature

Ghosh,

Kumar

2024

Ann Coloproctol

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The malignant transformation of chronic fistula in ano is rare, accounting for 3% to 11% of all anal canal malignancies. It results from long-standing inflammation and chronic irritation. No guidelines are available for the management of these cases. We herein present a case report of a 55-year-old man who presented with a history of constipation, perianal pain, and discharging fistula in ano of 4-year duration and underwent fistula surgery with recurrence. Biopsy of the fistulous tract revealed adenocarcinoma. He received neoadjuvant chemoradiotherapy, followed by abdominoperineal excision including excision of the fistulous tract. After 18 months of follow-up, he is free of recurrence. We present this case with a review of the literature, highlighting the management strategies.

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Section: Discussionmentioning

confidence: 99%

“…However, studies comparing these surgical techniques are not available. The 2 largest series were published by authors from Japan; those reports documented better survival with surgery only, and the majority of patients in their series underwent APE [ 8 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

Chronic fistula in ano associated with adenocarcinoma: a case report with a review of the literature

Ghosh,

Kumar

2024

Ann Coloproctol

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“…In a study of 42 cases of anal fistula cancers at our institution, we found 76% (32/42) mucinous and 19% (8/42) tubular adenocarcinomas. [ 2 ] In a study of 75 cases including anal fistula cancers related to CD, the histopathological types were reported as 68% (51/75) mucinous and 23% (17/75) tubular adenocarcinomas. [ 9 ] The findings of the present study were similar to the results of these reports, with frequencies of mucinous and tubular adenocarcinomas in anal fistula cancers of approximately 70% and 20%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…In a review of the clinical pathology and treatment results of 42 cases of anal fistula cancer at our hospital, the tumors identified were 32 mucinous adenocarcinomas, 8 tubular type adenocarcinomas, 1 adenosquamous carcinoma, and 1 squamous carcinoma. [2] In a review of the histopathology of 75 cases of anal fistula cancer in Crohn disease (CD), 51 were mucinous adenocarcinomas and 17 tubular type adenocarcinomas. [5] Abdominoperineal resection is the first line of treatment for anal fistula cancers.…”

Section: Introductionmentioning

confidence: 99%

“…Cancer arising from a fistula in the rectal-anal region (anal fistula cancer) is a malignant type of tumor associated with long-term anal fistulas and is reported to account for approximately 2% to 3% of colorectal cancers. [ 1 , 2 ] The World Health Organization states that anal fistula cancers originate from existing anal glands and fistula tracts. [ 3 ] The early diagnosis of anal fistula carcinoma is difficult because of the lack of early clinical symptoms due to its occurrence in a complex and intricate anal fistula tract.…”

Section: Introductionmentioning

confidence: 99%

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Value of apparent diffusion coefficient on MRI for prediction of histopathological type in anal fistula cancer

et al. 2023

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The main histopathological types of anal fistula cancers are mucinous adenocarcinoma and tubular adenocarcinoma. The purpose of this study was to investigate the utility of the apparent diffusion coefficient (ADC) value in magnetic resonance imaging (MRI) to determine the histopathological type of an anal fistula cancer, and to investigate the relationship between ADC values and histopathological type (mucinous type or tubular carcinoma), clinical information, and surgical findings. We retrospectively identified 69 patients diagnosed with anal fistula cancer at our hospital from January 2013 to December 2021. Among them, we selected the patients diagnosed using the same 1.5-T MRI machine, underwent surgery, and a pathological sample was obtained during the operation. Finally, these 25 patients were selected for the analysis since they underwent the imaging scan using the same MRI machine. The ADC value was compared between mucinous and tubular adenocarcinomas, and between tumors at the Tis-T1-T2 and T3-T4 stages. Finally, 25 patients were selected. The mean age of the 25 patients included in the analysis was 60.8 ± 13.3 years and all were males. The median ADC of anal fistula cancers was 1.97 × 10 –3 mm 2 /s for mucinous adenocarcinomas and 1.36 × 10 –3 mm 2 /s for tubular adenocarcinomas; this difference was statistically significant ( P < .01). Furthermore, the median ADC was 1.62 × 10 –3 mm 2 /s for tumors in Tis-T1-T2 stages and 2.01 × 10 –3 mm 2 /s for T3-T4 tumors ( P = .02). The ADC value in MR images may predict the histopathological type and depth of anal fistula cancers. Also, the different ADC values between Tis-T1-T2 and T3-T4 tumors could help predict the classification of progression.

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痔瘻癌早期診断のための特徴的臨床所見の検討

Suzuki,

Sashiyama,

Suzuki

et al. 2024

Nihon Daicho Komonbyo Gakkai Zasshi

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Aim: Identification of characteristic clinical findings for early diagnosis of carcinoma associated with anal fistula. Methods: From the perspective of early diagnosis, we compared the clinical characteristics of 13 cases of carcinoma associated with anal fistula with 5 clinical diagnostic criteria defined by Sumikoshi et al. Results: Pain and induration, absence of primary cancer at other sites, and presence of the fistula opening were observed in all cases, while mucinous secretion was observed in 8 cases and duration of anal fistula for more than 10 years in only 5 cases. Pain not relieved by drainage and marked induration without elasticity are differential points from abscesses. MRI showed hyperintense heterogeneous multifocal cystic lesions in 86% of cases, and endoanal ultrasonography (EAUS)showed lattice structures with septations of various sizes and isoechoic solid components in 83% of cases, all of which were useful for early diagnosis. Conclusions:The following four findings were useful for early diagnosis: 1) extensive severe induration, 2) pain not relieved by drainage, 3) mucinous secretion, and 4) characteristic MRI/EAUS findings. If even one of these is present, carcinoma associated with anal fistula should be strongly suspected and aggressive biopsy should be performed.

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Clinicopathological Characteristics and Clinical Outcomes of Anal Fistula Cancer in 42 Patients

Cited by 3 publications

References 2 publications

Chronic fistula in ano associated with adenocarcinoma: a case report with a review of the literature

Chronic fistula in ano associated with adenocarcinoma: a case report with a review of the literature

Value of apparent diffusion coefficient on MRI for prediction of histopathological type in anal fistula cancer

痔瘻癌早期診断のための特徴的臨床所見の検討

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