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01.12.2012 | Case report | Ausgabe 1/2012 Open Access

World Journal of Surgical Oncology 1/2012

Rectosigmoid adenocarcinoma revealed by metastatic anal fistula. The visible part of the iceberg: a report of two cases with literature review

World Journal of Surgical Oncology > Ausgabe 1/2012
El Bachir Benjelloun, Said Aitalalim, Leila Chbani, Ihsan Mellouki, Khalid Mazaz, Kahlid Aittaleb
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1477-7819-10-209) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

BEB has made substantial contributions to conception, bibliography and drafting the manuscript. AS has been involved in drafting the manuscript. CL has been involved in bibliography research and conception of pathology figures. IM and KM have been involved in or revising it critically for important intellectual content. KA has given final approval of the version to be published. All authors read and approved the final manuscript.


Colonic adenocarcinoma revealed by metastatic anorectal fistula is rare, with few cases in the literature. Such lesions can be taken for the more common manifestation of a benign perianal abscess or fistula. Once diagnosed, the management of such conditions remains controversial. We herein report two cases with perianal fistula that were subsequently found to have developed perianal adenocarcinoma on biopsy. Further colonic investigation revealed a rectosigmoid adenocarcinoma. Histology and immunohistochemical staining was identical in both primary and metastatic tumors. Preoperative chemoradiation with further rectal low anterior resection and local excision of metastatic anal fistula was performed. There is no recurrence after 3 years of follow-up.
Authors’ original file for figure 1
Authors’ original file for figure 2
Authors’ original file for figure 3
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