A Case of an Anal Canal Cancer Manifesting As an Extended Fournier's Gangrene

Yutaka Shiino and Shunzo Ozaki

Department of Surgery, Musashino General Hospital

Fournier's gangrene is a rare, rapidly progressive and potentially fatal gangrenous infection of the perineum and genitalia. A 62-year-old man, who had previously undergone three operations for the anal fistula, was hospitalized complaining of a high-grade fever and anal pain. An initial incision was made to drain the abscess in the perianal area. Four days later, extended incisions, lavage, debridement and drainage all the way down to the left calf were performed in conjunction with the creation of a sigmoid colostomy for fecal diversion. Rectal examination revealed a fixed and obstructing induration. Abscess cultures yielded Escherichia coli and four other anaerobic organisms. Hyperbaric oxygen therapy was delivered for ten days. Following a histopathologic diagnosis of anal canal cancer, a curative abdominal perineal resection was performed. Histopathology revealed a stage IIIB (T2N2M0), moderately differentiated adenocarcinoma. We experienced a rare case of an advanced adenocarcinoma of the anal canal manifesting as a perianal abscess progressing to extended Fournier's gangrene.

Key words
Fournier's gangrene, anal canal cancer, perianal abscess

Reprint requests
Yutaka Shiino Department of Surgery, Musashino General Hospital 977-9 Obukuroshinden, Kawagoe, 350-1167 JAPAN

Accepted
May 27, 2003

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