A Case of Anal Cancer Arised from a Long-Standing Anal Fistula of about 40-years

Shinya Nomura, Kiyoshi Maeda, Naoyoshi Onoda, Shinichiro Kashiwagi, Masakazu Yashiro and Kosei Hirakawa

Department of Surgical Oncology, Osaka City University Graduate School of Medicine

A 58-year-old man who had been suffering from an anal fistula with purulent discharge for about 40 years was admitted to our hospital for severe anal pain. Biopsy specimens from the fistular wall showed adenosquamous carcinoma. Further examination revealed that extensive invasion of the sacrum, therefore, after radiation therapy combined with anticancer chemotherapy, an abdominoperineal excision was performed. Histological examination of the resected specimens showed necrosis in the majority of the tumor cells. The patient was discharged 52 days after surgery without any major complication. Preoperative radiation therapy combined with chemotherapy was considered to be effective for advanced anal fistula cancer in which preservation of a safe surgical margin might be difficult intraoperatively.

Key words
chronic anal fistula, fistula cancer

Reprint requests
Kiyoshi Maeda Department of Surgical Oncology, Osaka City University Graduate School of Medicine 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585 JAPAN

Accepted
May 27, 2003

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