克罗恩病患者肛门阴道瘘并发腺癌。
Adenocarcinoma in an ano-vaginal fistula in Crohn's disease.
作者信息
Alfa-Wali Maryam, Atinga Angela, Mohsen Yasser, Anthony Andrew, Myers Alistair
机构信息
Hillingdon Hospital NHS Foundation Trust, United Kingdom.
出版信息
Int J Surg Case Rep. 2013;4(7):579-82. doi: 10.1016/j.ijscr.2013.04.007. Epub 2013 Apr 18.
INTRODUCTION
Fistulas are a relatively common occurrence in Crohn's disease (CD), and often present early in the disease process. Additionally, patients suffering from either CD or ulcerative colitis are shown to have an increased risk of colorectal malignancies compared with the general population.
PRESENTATION OF CASE
We present a case of adenocarcinoma in an ano-vaginal fistula in a patient with longstanding CD.
DISCUSSION
Various pathogenic mechanisms for the development of carcinoma in fistulas have been suggested, but there is no consensus and indeed this risk may be cumulative. In this case report, we also discuss the pathogenesis of mucinous adenocarcinoma in fistulas secondary to CD.
CONCLUSION
Better detection of adenocarcinoma in patients presenting with persistent non-resolving fistulas in the presence of CD should be undertaken with regular biopsies following examinations under anaesthetic of the anorectum.
引言
瘘管在克罗恩病（CD）中较为常见，且常出现在疾病进程的早期。此外，与普通人群相比，患有CD或溃疡性结肠炎的患者患结直肠癌的风险更高。
病例介绍
我们报告一例长期患有CD的患者，其肛门阴道瘘发生腺癌。
讨论
关于瘘管中癌发生的各种致病机制已被提出，但尚无共识，而且这种风险可能是累积性的。在本病例报告中，我们还讨论了CD继发瘘管中黏液腺癌的发病机制。
结论
对于患有CD且存在持续性不愈合瘘管的患者，应在直肠肛管麻醉检查后定期进行活检，以更好地检测腺癌。
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