A Case of Metastatic Carcinoma of Anal Fistula Caused by Implantation of Rectal Cancer

Yasuhiro Yuasa, Hiroshi Okitsu, Hiromitsu Takizawa, Hisashi Ishikura, Toshihiro Ichimori, Masashi Ishikawa, Suguru Kimura, Akihiro Sakata and Yoshiyuki Fujii*

Department of Surgery and Department of Pathology*, Tokushima Red Cross Hospital

A 48-year-old man with a 6-month history of anal fistula admitted for anal pain and a rectal tumor was found in examination of the perianal lesion to have a 1.5-cm-diameter mass in the upper right anus. Colonoscopy confirmed the presence of a circular mass at the rectum (Rb). Tumor biopsy showed moderately differentiated adenocarcinoma necessitating abdominoperineal resection (D3) with wide excision of the left perianal lesion. The perianal tumor showed the same histological appearance as the rectal cancer and no mucoid discharge common in carcinoma of anal gland origin was seen, so we assumed that free tumor cells from rectal cancer may have been implanted in the anal fistula.

Key words
metastatic carcinoma of anal fistula, implantation

Reprint requests
Yasuhiro Yuasa Department of Surgery, Tokushima Red Cross Hospital
28-1 Shinbiraki, Chuden-cho, Komatsushima, 773-8502 JAPAN

Accepted
January 25, 2006

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