A Case of Matastatic Carcinoma of Anal Fistula Caused Implantation from Rectal Cancer

Hisashi Yoshimura, Tetsuya Ienaga, Shinsaku Ueda^*and Takeyoshi Ota

Department of Surgery, Takatsuki General Hospital ^*Department of Surgery, Rokko Hospital

A 59-year-old man with 30-year history of anal fistula was admitted to our hospital reporting a growing perianal tumor. At the right side of the anus, the tumor was palpable, at 5 cm in diameter. Pus was discharged from the fistula through the tumor. Computed tomography (CT) and magnetic resonance imaging (MRI) showed an abcess and fistula beside the tumor. Rectal cancer was found 10 cm from the anus by colonoscopy. A biopsy was done and revealed moderately differentiated adenocarcinoma. We conducted abdominoperineal resection (D2) for the perianal tumor and resected right inguinal lymph nodes. The anal defect was repaired with a gracilis myocutaneous flap. The perianal tumor showed the same histological appearance as the rectal cancer, so we concluded that free tumor cells from the rectal cancer may have been implanted in the anal fistula.

Key words
implantation, carcinoma of anal fistula

Reprint requests
Hisashi Yoshimura Department of Surgery, Takatuki General Hosspital 1-3-13 Kosobe-cho, Takatuki, 569-1192 JAPAN

Accepted
April 25, 2001

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