General Surgery, CHU Tivoli, La Louvière, Belgium.
Department of Digestive Surgery, CHU Tivoli, La Louvière, Belgium.
Acta Chir Belg. 2024 Apr;124(2):143-146. doi: 10.1080/00015458.2023.2205722. Epub 2023 Sep 5.
Crohn's disease patients frequently develop perianal fistulas during their life. They are also at higher risk to develop cancers. Rarely, those cancers appear within a prior chronic fistula. The main types are adenocarcinoma mostly mucinous and squamous cell carcinoma. They are generally discovered at an advanced stage with a poor prognosis because symptoms are generally the same as those of the fistula itself. Regular follow-up of chronic fistulas is then important for an early diagnosis as well as histological analysis of the fistula during surgery. There is no consensus on the ideal treatment but abdominoperineal resection is the corner stone with or without neo or adjuvant chemo-radiotherapy. This paper presents a rare case of mucinous adenocarcinoma in a chronic perianal fistula in a Crohn's disease female and provides a review of the literature.
克罗恩病患者在其一生中经常会发展为肛周瘘，且他们发生癌症的风险更高。罕见情况下，这些癌症出现在先前的慢性瘘管内。主要类型为腺癌（主要为黏液腺癌）和鳞状细胞癌。由于症状通常与瘘管本身相同，因此这些癌症通常在晚期被发现，预后较差。因此，对慢性瘘管进行定期随访对于早期诊断以及手术期间对瘘管进行组织学分析非常重要。对于理想的治疗方法尚未达成共识，但经腹会阴切除术是基石，可联合或不联合新辅助化疗-放疗。本文介绍了一例克罗恩病女性慢性肛周瘘中罕见的黏液性腺癌病例，并对文献进行了回顾。
