Anal Canal Adenocarcinoma in a Patient with Longstanding Crohn’s Disease Arising From Rectal Mucosa that Migrated From a Previously Treated Rectovaginal Fistula

Content Provider	Semantic Scholar
Author	Maejima, Taku Kono, Toru Orii, Fumika Maemoto, Atsuo Furukawa, Shigeru Liming, Wang Kasai, Shoji Fukahori, Susumu Mukai, Nobutaka Yoshikawa, Daitaro Karasaki, Hidenori Saito, Hiroya Nagashima, Kazuo
Copyright Year	2016
Abstract	BACKGROUND This study reports the pathogenesis of anal canal adenocarcinoma in a patient with longstanding Crohn's disease (CD). CASE REPORT A 50-year-old woman with a 33-year history of CD presented with perianal pain of several months' duration. She had been treated surgically for a rectovaginal fistula 26 years earlier and had been treated with infliximab (IFX) for the previous 4 years. A biopsy under anesthesia revealed an anal canal adenocarcinoma, which was removed by abdominoperineal resection. Pathological examination showed that a large part of the tumor consisted of mucinous adenocarcinoma at the same location as the rectovaginal fistula had been removed 26 years earlier. There was no evidence of recurrent rectovaginal fistula, but thick fibers surrounded the tumor, likely representing part of the previous rectovaginal fistula. Immunohistochemical analysis using antibodies against cytokeratins (CK20 and CK7) revealed that the adenocarcinoma arose from the rectal mucosa, not the anal glands. CONCLUSIONS Mucinous adenocarcinoma can arise in patients with CD, even in the absence of longstanding perianal disease, and may be associated with adenomatous transformation of the epithelial lining in a former fistula tract.
Starting Page	448
Ending Page	453
Page Count	6
File Format	PDF HTM / HTML
PubMed reference number	27373845
Volume Number	17
Journal	The American journal of case reports
Language	English
Access Restriction	Open
Subject Keyword	Adenocarcinoma, Tubular Anal canal adenocarcinoma Anus Crohn Disease Cytokeratin Ifosfamide Mucinous Adenocarcinoma Mucins Mucous Membrane Muscle layer Neoplasms Operative Surgical Procedures Pain Patients Perianal Rectovaginal Fistula Signs and Symptoms Structure of anal gland Submucosa TUBE,RECTAL,24FR,PLASTIC B#6510 Tissue fiber Tracheoesophageal Fistula Ulcer infliximab pathologic fistula
Content Type	Text
Resource Type	Article