Buchman A L, Ament M E, Doty J
Department of Surgery, UCLA Medical Center.
Am J Gastroenterol. 1991 Dec;86(12):1829-32.
Two patients with Crohn's disease who developed squamous cell carcinoma in chronic sinus tracts are reported. Because nonhealing perineal sinus tracts or fistulas are relatively common in patients with Crohn's disease, the diagnosis of carcinoma may not be considered until the malignancy is advanced. Because of the potential for a surgical and oncologic "cure," early diagnosis may improve the prognosis. Malignancy should be considered in patients with nonhealing perineal sinuses who develop severe continuous perianal pain. Diagnosis is best made by needle aspiration cytology and sinus tract biopsy. Treatment should include wide excision of the sinus tract, surrounding soft tissue, and lymph nodes, followed by chemotherapy and radiotherapy in selected cases.
报告了两名克罗恩病患者，他们在慢性窦道中发生了鳞状细胞癌。由于会阴窦道或瘘管不愈合在克罗恩病患者中相对常见，在恶性肿瘤进展之前可能不会考虑癌症诊断。鉴于存在手术和肿瘤学“治愈”的可能性，早期诊断可能会改善预后。对于会阴窦道不愈合且出现严重持续性肛周疼痛的患者，应考虑恶性肿瘤的可能。最佳诊断方法是针吸细胞学检查和窦道活检。治疗应包括广泛切除窦道、周围软组织和淋巴结，部分病例随后进行化疗和放疗。
