A Case of Double Cancers in the Rectum and Anal Fistula

Osamu Ogura, Shousaburo Maeda, Kazutaka Yamada*, Takashi Ishizawa*, Masamichi Goto**, Hisaaki Shimazu*

Department of Surgery, Ogura Memorial Hospital
First Department of Surgery* and Department of Pathology**, School of Medicine, Kagoshima University

A case of double cancers in the rectum and anal fistula is described. The patient was a 59-year-old male who had been suffering from anal fistula for five years. He was admitted to our hospital with the complaint of anal bleeding and was diagnosed as having rectal cancer by barium meal enema. Low anterior resection was carried out for rectal cancer, and fistulectomy was done for anal fistula four weeks later. Histological examination of the fistulectomy specimen disclosed a focus of well-differentiated adenocarcinoma in the epithelium of the fistulous tract. The rectal cancer was located high in the upper rectum. The second cancer focus was very small, measuring 3 mm in size and situated locally in the inner surface of the fistulous tract with its internal opening in the anal crypt. Thus, the two malignant lesions were considered likely to be double cancers occurred that synchronously.

Key words
rectal cancer, cancer of anal fistula, double cancers of rectum and anal fistula

Reprint requests
Osamu Ogura Division of Surgery, Ogura Memorial Hosital
8-21-2 Kotobuki, Kanoya City, Kagoshima 893 JAPAN

Accepted
October 9, 1991

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