Mucinous adenocarcinoma associated with fistula in ano: report of a case

Abstract

We present a case of the rare occurrence of a mucus-secreting adenocarcinoma originating in an anal gland. A 37-year-old diabetic man had an anal fistulotomy 16 years before. He had four ischiorectal abscesses in a 6-month period. A seton was inserted in a complex fistula tract in the left anterior lateral aspect. Due to delayed healing, a new surgical exploration was carried out; pathological analysis of the curetted mucinous tissue revealed a mucoid adenocarcinoma. Surgical resection is the first choice of curative treatment, and additional treatments include chemotherapy, radiotherapy and brachytherapy.

Mucinous adenocarcinoma of perianal region: an uncommon disease treated with neo-adjuvant chemo-radiation

“…Rosser (8) postulated three criteria for describing the pathophysiology of this unusual entity; the fistula may precede the carcinoma by at least 10 years, the fistula opens inside the anal canal and outside the tumor and any anorectal cancer should be an extension from the fistula harboring the carcinoma. Few cases have reported anal ducts and glands as the origin of perianal pathology (11). These ducts and glands may pierce the internal sphincter muscle before they extend to the perianal area in the ischiorectal fossa thus forming anal fistulas and perianal abscesses.…”

Fistula-Associated Anal Adenocarcinoma: Good Results with Aggressive Therapy

“…Adenocarcinomas and squamous-cell carcinomas have both arisen in nonhealing fistula tracts (Table 4). 7,8,[18][19][20][21][22][23][24][25][26][27] Long-standing fistulas of the gastrointestinal and bronchopulmonary systems have been the most widely affected by malignant transformation. [28][29][30] Chronic infection and inflammation (i.e., Crohn's disease and radiation) are the most frequently associated risk factors.…”

Mucinous adenocarcinoma arising from chronic perianal fistula mimicking horseshoe abscess

“…Thus, luminal obstruction and bleeding per rectum are not usual presentations in these cases 1 3 8. Even on digital rectal examination, the mass might not be perceived and only a thickened indurated area is appreciated towards the side of fistula 7. One important clue to diagnosis can be obtained from mucinous instead of purulent discharge from the fistula 12.…”