Mucinous adenocarcinoma arising from fistula-in-ano: findings on MRI

Abstract

Sir,We report on a case of mucinous adenocarcinoma arising from a fistula-in-ano, which formed a huge subcutaneous mass in the buttock.A 68-year-old diabetic man was referred to our hospital. Two years prior to the admission, the patient had first recognized a small subcutaneous nodule which gradually increased in size. On admission, he complained of a spontaneous pain. The mass measured 12×7 cm, and the covering skin had some ulcers with a foul smell.A contrast-enhanced transverse T1-weighted MR image (Fig. 1) revealed a huge cystic mass. The wall showed marked contrast uptake. Some enhancing solid components were also disclosed. The content showed homogenous low signal intensity on T1-weighted images, whereas a T2-weighted image (not shown) revealed marked hyperintensity.On another transverse image (Fig. 2), which was obtained at the cranial aspect of the lesion, a tubular structure was disclosed. This finding implied a fistula between the mass and the anus, although no direct continuity was identified.These MR findings in conjunction with the clinical course strongly sugEur Radiol (

A case of mucinous adenocarcinoma arising in long-standing multiple perianal and presacral fistulas

“…However, the patient survived for 3 years, developing fistula recurrence but not distant metastases. So, in this case, we can conclude that tumour progression was slower than that observed in squamous cell carcinoma [1,2].…”

“…Surgical resection is the first priority of curative treatment [1][2][3], whereas radiotherapy alone or with chemotherapy can be an adjuvant therapeutic option with favourable prognosis [3][4][5]. Below, we present a case of mucinous perianal carcinoma successfully treated by surgical resection alone.…”

Diagnostic implications of MR imaging for mucinous adenocarcinoma arising from fistula in ano

“…The majority of mucinous adenocarcinomas typically show low-signal intensity on T1-weighted and a markedly high-signal intensity on T2-weighted MR images [6]. A previous report suggested that a fistula between the mass and the anus is a characteristic finding of mucinous adenocarcinoma arising from fistula in ano [7]. It has been suggested that markedly hyperintense content on T2-weighted images reflects the mucin pool of mucinous adenocarcinomas [6].…”

Is histopathological evidence really essential for making a surgical decision about mucinous carcinoma arising in a perianal fistula? Report of a case

“…19 Diagnosis can be based on the following three characteristic fi ndings on magnetic resonance imaging: hyperintense fl uid on T2-weighted images; enhanced solid components; and a fi stula between the mass and the anus. [20][21][22] Histological examination of the resected specimen from this patient revealed clusters of cancer cells fl oating in a mucous lake, which explained the diffi culty in obtaining cancer cells by needle biopsy (Fig. 4a-c).…”