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病例报告:克罗恩病直肠切除术后晚期肛周黏液腺癌:一种肿瘤学上的罕见病例。

Case report: late perianal mucinous adenocarcinoma after Crohn's disease proctectomy: an oncological rarity.

作者信息

Keese Michael, Back Walter, Dinter Dietmar, Gladisch Rainer, Joos Andreas, Palma Pablo

机构信息

Department of Surgery, University Hospital of Mannheim, 68135 Mannheim, Germany.

出版信息

World J Surg Oncol. 2005 Jun 29;3:42. doi: 10.1186/1477-7819-3-42.

Abstract

BACKGROUND

As in ulcerative colitis, there is an increased incidence of colorectal carcinoma in Crohn's disease. While carcinoma formation originating from ano-rectal fistulas is generally considered as a rare event there are different publications reporting on mucinous adenocarcinoma formation in association with a neovagina and rectovaginal fistulas. To the best of our knowledge this is the first description of a perianal mucinous adenocarcinoma arising in a patient after Crohn's disease proctocolectomy.

CASE PRESENTATION

We report the case of a 50-year old female with a mucinous adenocarcinoma forming in the perineum eleven years after proctocolectomy for Crohn's disease. The patient was readmitted with perineal pain, leucocytosis and a perineal mass highly suspicious of abscess formation in the MRI-Scan. Histological examination revealed a mucinous adenocarcinoma. Exenteration including vagina, uterus and ovaries together with the coccygeal-bone was performed.

CONCLUSION

Mucinous adenocarcinoma formation is a rare complication of Crohn's disease and so far unreported after proctocolectomy.

摘要

背景

与溃疡性结肠炎一样,克罗恩病患者结直肠癌的发病率也有所增加。虽然起源于肛门直肠瘘的癌形成通常被认为是罕见事件,但有不同的出版物报道了与新阴道和直肠阴道瘘相关的黏液腺癌形成。据我们所知,这是克罗恩病直肠结肠切除术后患者发生肛周黏液腺癌的首次描述。

病例报告

我们报告了一名50岁女性的病例,该患者在因克罗恩病行直肠结肠切除术后11年,会阴部形成黏液腺癌。患者因会阴部疼痛、白细胞增多以及MRI扫描显示高度怀疑脓肿形成的会阴部肿块而再次入院。组织学检查显示为黏液腺癌。进行了包括阴道、子宫和卵巢以及尾骨的扩大切除术。

结论

黏液腺癌形成是克罗恩病的一种罕见并发症,迄今为止在直肠结肠切除术后尚未见报道。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c64/1190221/0c62b8e377b1/1477-7819-3-42-1.jpg

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