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肛周瘘管的黏液腺癌。一种新出现的实体瘤?

Mucinous adenocarcinoma on perianal fistula. A rising entity?

机构信息

Colorectal Unit, Surgery Department, Hospital Universitario de Cabueñes, Gijón, Spain.

Pathology Department, Hospital Universitario de Cabueñes, Gijón, Spain.

出版信息

Clin Transl Oncol. 2018 May;20(5):666-669. doi: 10.1007/s12094-017-1750-y. Epub 2017 Sep 19.

Abstract

INTRODUCTION

Mucinous adenocarcinoma on perianal fistula is a rare entity; it could be underdiagnosed because it behaves often as a regular perianal fistula.

MATERIALS AND METHODS

We have recently treated four cases in our unit. We present them and review the literature, emphasizing on clinical characteristic and therapeutic options. The four patients were male with a mean age of 64. Three of them were classified as locally advances cases and therefore treated with neoadjuvant therapy.

RESULTS

All of them underwent laparoscopic abdominoperineal escisión. Surgical specimens are described and clinical characteristic specified. Review of the literature shows that this disease has a very high potential risk of local recurrence and we must be aggressive with the resection. Sometimes plastic surgery is needed to reconstruct the perianal wound.

CONCLUSIONS

Mucinous adenocarcinoma associated with anal fistula is a rare disease. Neoadjuvant chemoradiotherapy followed by an adequate abdominoperineal excision may result in favourable outcomes.

摘要

引言

肛周瘘管的黏液腺癌较为罕见,因为其表现通常与普通肛周瘘管相似,故可能被误诊。

材料与方法

我们近期在科室中治疗了 4 例此类患者。我们对这些病例进行了介绍,并复习了文献,重点讨论了其临床特征和治疗选择。4 例患者均为男性,平均年龄为 64 岁。其中 3 例为局部进展期病例,因此采用新辅助治疗。

结果

所有患者均接受了腹腔镜经腹会阴联合切除术。描述了手术标本,并明确了临床特征。文献复习表明,该疾病具有很高的局部复发风险,因此必须积极进行切除。有时需要整形手术来重建肛周伤口。

结论

肛周瘘管伴发黏液腺癌较为罕见。新辅助放化疗后进行充分的经腹会阴联合切除术可能会取得良好的效果。

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