Clinical and Translational Oncology

, Volume 20, Issue 5, pp 666–669 | Cite as

Mucinous adenocarcinoma on perianal fistula. A rising entity?

  • C. J. Alvarez-Laso
  • S. Moral
  • D. Rodríguez
  • A. Carrocera
  • E. Azcano
  • A. Cabrera
  • R. Rodríguez
Brief Research Article
  • 71 Downloads

Abstract

Introduction

Mucinous adenocarcinoma on perianal fistula is a rare entity; it could be underdiagnosed because it behaves often as a regular perianal fistula.

Materials and methods

We have recently treated four cases in our unit. We present them and review the literature, emphasizing on clinical characteristic and therapeutic options. The four patients were male with a mean age of 64. Three of them were classified as locally advances cases and therefore treated with neoadjuvant therapy.

Results

All of them underwent laparoscopic abdominoperineal escisión. Surgical specimens are described and clinical characteristic specified. Review of the literature shows that this disease has a very high potential risk of local recurrence and we must be aggressive with the resection. Sometimes plastic surgery is needed to reconstruct the perianal wound.

Conclusions

Mucinous adenocarcinoma associated with anal fistula is a rare disease. Neoadjuvant chemoradiotherapy followed by an adequate abdominoperineal excision may result in favourable outcomes.

Keywords

Mucinous adenocarcinoma Anal fistula Neoadjuvant therapy 

Notes

Compliance with ethical standards

Ethical standards

The manuscript does not contain clinical studies or patient data.

Conflict of interest

Authors declare that we have no conflict of interest.

Informed consent

Informed consent was obtained from all patients.

References

  1. 1.
    Rosser C. The relation of fistula-in-ano to cancer of the anal canal. Trans Am Proc Soc. 1934;35:65–71.Google Scholar
  2. 2.
    Pai VD, Jatal S, Engineer R, Ostwal V, Saklani AP. Multidisciplinary management of colorectal adenocarcinoma associated with anal fistula: an Indian series. Colorectal Dis. 2015;17(11):240–6.CrossRefGoogle Scholar
  3. 3.
    Hongo K, Kazama S, Sunami E, Kitayama J, Watanabe T. Perianal adenocarcinoma associated with anal fistula: a report of 11 cases in a single institution focusing on treatment and literature review. Hepatogastroenterology. 2013;60:720–6.PubMedGoogle Scholar
  4. 4.
    Gaertner WB, Hagerman GF, Finne CO, Alavi K, Jessurun J, Rothenberger DA, et al. Fistula associated anal adenocarcinoma: good results with aggressive therapy. Dis Colon Rectum. 2008;51:1061–7.CrossRefPubMedGoogle Scholar
  5. 5.
    Okada K-I, Shatari T, Sasaki Tamada T, Suwa T, Furuuchi T, et al. Is histopathological evidence really essential for making a surgical decision about mucinous carcinoma arising in a perianal fistula? Report of a case. Surg Today. 2008;38:555–8.CrossRefPubMedGoogle Scholar
  6. 6.
    Rollinson PD, Dundas SA. Adenocarcinoma of sigmoid colon seeding into pre-existing fistula in ano. Br J Surg. 1984;71:664–5.CrossRefPubMedGoogle Scholar
  7. 7.
    Yamaguchi T, Kagawa R, Takahashi H, Takeda R, Sakata S, Nishizaki D. Diagnostic implications of MR imaging for mucinous adenocarcinoma arising from fistula in ano. Tech Coloproctol 2009;13(3):251–3.CrossRefPubMedGoogle Scholar
  8. 8.
    Samajima S, Sawada T, Nagasako K. Squamous cell carcinoma of anus and carcinoma in association with anal fistula in Japan, multiinstitutional registration. J Jpn Soc Coloproctol. 2005;58:415–21.CrossRefGoogle Scholar

Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2017

Authors and Affiliations

  1. 1.Colorectal Unit, Surgery DepartmentHospital Universitario de CabueñesGijónSpain
  2. 2.Pathology DepartmentHospital Universitario de CabueñesGijónSpain

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