Sato Harunobu, Shiota Miho, Kiriyama Yuka, Tsukamoto Tetsuya, Honda Katsuyuki, Uyama Ichiro
Department of Surgery, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192 Japan.
Department of Pathology, School of Medicine, Fujita Health University, Toyoake, Japan.
Int Cancer Conf J. 2021 Jan 5;10(2):139-143. doi: 10.1007/s13691-020-00465-9. eCollection 2021 Apr.
Colorectal cancer (CRC) rarely spreads by implantation. We report a case of implantation of rectosigmoid cancer in an anal fissure. A 70-year-old woman with a 15-year medical history of anal fissure was referred to our hospital with anal pain of 3-month duration. Colonoscopy revealed a rectosigmoid tumor and a 10-mm submucosal tumor at the anal verge. Biopsy of the rectosigmoid and anal tumors revealed that both were moderately differentiated adenocarcinomas, and abdominoperineal resection (APR) was performed. The anal adenocarcinoma was surrounded by squamous cell epithelium and mainly proliferated in the submucosal and muscular layers. The patient was diagnosed as having rectosigmoid cancer with implantation of cancer in a preexisting anal fissure. The patient remains well 43 months post-surgery with no sign of recurrence. Implantation of CRC in anal fissure is a rare occurrence. Nevertheless, performing adequate anal examination of patients with CRC before surgery and during follow-up is necessary. Further, it is important to perform preoperative large bowel examination of patients with benign anal diseases to prevent implantation of CRC.
结直肠癌（CRC）很少通过种植转移。我们报告一例乙状结肠直肠癌种植于肛裂的病例。一名有15年肛裂病史的70岁女性因持续3个月的肛门疼痛转诊至我院。结肠镜检查发现乙状结肠有一肿瘤，肛门边缘有一个10毫米的黏膜下肿瘤。乙状结肠和肛门肿瘤活检显示两者均为中分化腺癌，遂行腹会阴联合切除术（APR）。肛门腺癌被鳞状上皮包围，主要在黏膜下层和肌层增殖。该患者被诊断为乙状结肠直肠癌伴癌种植于既往存在的肛裂。患者术后43个月情况良好，无复发迹象。CRC种植于肛裂是一种罕见情况。尽管如此，术前及随访期间对CRC患者进行充分的肛门检查是必要的。此外，对患有良性肛门疾病的患者进行术前大肠检查以预防CRC种植也很重要。
