Prasad Surya Nandan, Razik Abdul, Siddiqui Farhana, Lal Hira
Department of Radiodiagnosis, SGPGIMS, Lucknow, Uttar Pradesh, India.
Department of Radiodiagnosis, All India Institute Of Medical Sciences, New Delhi, India.
BMJ Case Rep. 2018 Apr 5;2018:bcr-2017-223063. doi: 10.1136/bcr-2017-223063.
Perianal fistulae are commonly seen clinical entity. Development of malignancy within a perianal fistula is rare. Even rarer is the development of mucinous adenocarcinoma in a chronic fistula-in-ano. Only a handful of such cases have been reported in the past. A case of mucinous adenocarcinoma arising in chronic perianal fistula in a 34-year-old woman is being described. She presented with complaints of perineal fullness, pain and recurrent pus discharge from perianal fistula for 4 years. On radiological workup, a large solid-cystic pelvic mass was seen in relation to the fistula. On MRI, the lesion was mimicking a large horseshoe abscess. Transrectal ultrasound-guided biopsy and subsequent histopathological examination confirmed the presence of mucinous adenocarcinoma with tumour cells immunopositive for CK7 and CK20.
肛周瘘管是常见的临床病症。肛周瘘管内发生恶性肿瘤较为罕见。慢性肛瘘中发生黏液腺癌则更为罕见。过去仅报道过少数此类病例。本文描述了一名34岁女性慢性肛周瘘管中发生黏液腺癌的病例。她因会阴坠胀、疼痛及肛周瘘管反复流脓4年就诊。经影像学检查，发现与瘘管相关的盆腔有一个巨大的实性-囊性肿块。磁共振成像（MRI）显示该病变类似一个巨大的马蹄形脓肿。经直肠超声引导下活检及后续组织病理学检查证实为黏液腺癌，肿瘤细胞对细胞角蛋白7（CK7）和细胞角蛋白20（CK20）免疫阳性。
