Sato Yu, Ohki Shinji, Sassa Motoki, Tachibana Kazunoshin, Ando Jin, Endo Yoshiyuki, Suzuki Satoshi, Nakamura Izumi, Koyama Yoshihisa, Suzuki Shin-Ichi, Takenoshita Seiichi
Dept. of Organ Regulatory Surgery, Fukushima Medical University School of Medicine.
Gan To Kagaku Ryoho. 2011 Aug;38(8):1341-3.
A 66-year-old man with a 39-year history of anal fistula was admitted to our hospital for anal pain and bleeding. Fistulectomy was carried out for anal fistula. Histological examination of the specimen revealed carcinoma associated with anal fistula. A computed tomography showed that the tumor had invaded the prostate. Therefore, preoperative chemoradiotherapy(S-1 plus radiation 40 Gy/body)for locally advanced cancer was performed. Magnetic resonance imaging showed that the boundary between the tumor and the prostate was unclear, but we performed an abdominoperineal resection and the prostate was fully preserved. Histopathologically, no cancer cell existed on the surgical margin. The histological effect of chemoradiotherapy was judged as grade 2. This case suggested that surgical treatment combined with preoperative chemoradiotherapy may be effective for locally advanced carcinoma associated with anal fistula, in which preservation of adjacent organs is considered to be difficult.
一名患有肛瘘39年的66岁男性因肛门疼痛和出血入院。对肛瘘进行了瘘管切除术。标本的组织学检查显示为与肛瘘相关的癌。计算机断层扫描显示肿瘤已侵犯前列腺。因此，对局部晚期癌症进行了术前放化疗（S-1加40 Gy/体部放疗）。磁共振成像显示肿瘤与前列腺之间的边界不清楚，但我们进行了腹会阴切除术并完整保留了前列腺。组织病理学检查显示手术切缘无癌细胞。放化疗的组织学效果判定为2级。该病例表明，手术治疗联合术前放化疗可能对与肛瘘相关的局部晚期癌有效，而此类癌症通常认为难以保留相邻器官。
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