Abstract
Adenocarcinoma in the anal canal associated with an anal fistula is extremely rare, and in most cases its origin is difficult to ascertain because the primary sites have already been destroyed before any diagnosis of malignancy is able to be made. We report herein the case of a 62-year-old man found to have papillary adenocarcinoma with partial mucinous carcinoma associated with an anal fistula. The tumor was not exposed to the mucosal surface of the anal canal or rectum and an abdominoperineal resection was carried out. Macroscopic findings suggested that the tumor had developed from the anal fistula; however, the tumor showed a positive result when tested for O-acetylated sialic acids. This test also proved positive in the mucus of normal rectal mucosa, but not in the mucus of the anal glands. We speculated that the results of these tests may indicate that this tumor could have originated from the rectal mucosa, from where it migrated into the anal fistula.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Fenger C, Filipe MI (1977) Pathology of the anal glands with special reference to their mucin histochemistry. Acta Path Microbiol Scand [A] 85:273–285
Culling CFA, Reid PE, Clay MG, Dunn WL (1974) The histochemical demonstration of O-acylated sialic acid in gastrointestinal mucins. Their association with the potassium hydroxide-periodic acid-Schiff effect. J Histochem Cytochem 22:826–831
Dukes CE, Galvin C (1956) Colloid carcinoma arising within fistulae in the ano-rectal region. Ann R Coll Surg Engl 18:246–261
Zimberg YH, Kay S (1957) Anorectal carcinomas of extramucosal origin. Ann Surg 145:344–354
Nielsen OV, Koch F (1973) Carcinomas of the anorectal region of extramucosal origin with special reference to the anal ducts. Acta Chir Scand 139:299–305
Getz SB, Ough YD, Patterson RB, Kovalcik PJ (1981) Mucinous adenocarcinoma developing in chronic anal fistula: report of two cases and review of the literature. Dis Colon Rectum 24:562–566
Fujiwara A, Yoshida M, Kato Y, Yanagisawa A, Sugano H, Oota H, Takahashi T, Nishi M, Maruyama M (1987) Pathological study of carcinoma of the anal canal (in Japanese with English abstract). I to Cho (Stomach Intestine) 22:279–290
Hutchins JT, Reading CL, Giavazzi R, Hoaglund J, Jessup JM (1988) Distribution of mono-, di-, and tri-O-acetylated sialic acids in normal and neoplastic colon. Cancer Res 48:483–489
Ravindranath MH, Higa HH, Cooper EL, Paulson JC (1985) Purification and characterization of an O-acetyl sialic acid-specific lectin from a marine crab Cancer antennarius. J Biol Chem 260:8850–8856
Rosai J (1981) Anal fissue, ulcer, and fistula. In: Rosai J (ed) Ackerman's surgical pathology, 6th edn. Mosby, St. Louis, pp 560–561
Morson BC, Dawson IMP (1979) Adenocarcinoma in anorectal fistula. In: Morsen BC, Dawson IMP (eds) Gastrointestinal pathology, 2nd edn. Blackwell Scientific Publications, Oxford, pp 751–752
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Taniguchi, S., Yamanari, H., Inada, K. et al. Adenocarcinoma in the anal canal associated with a fistula: Report of a case. Surg Today 26, 707–710 (1996). https://doi.org/10.1007/BF00312089
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00312089