こう門管癌を合併したＣｒｏｈｎ病の１例

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  • Anal canal cancer associated with Crohn' s disease

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A 46-year-old man was diagnosed as Crohn's disease at the age of 33 years old. He underwent intestinal resection twice and indwelling of seton for intractable anal fistula. He complained of constipation and abdominal distention, and serum carcinoembryonic antigen (CEA) was increased. Although benign polyps were found in the anorectum, there was no lesion responsible for the high value of CEA. Sigmoid colostomy, transanal polypectomies and resection of skin tags in the anus were performed. Histologic examination of the anal polyp and skin tag revealed infiltration of adenocarcinoma into the subcutaneous layer. He underwent amputation of the rectum and dissection of mesorectal and inguinal lymph nodes. In the surgical specimen, a firm, irregular tumor was located at the primary opening of the anal fistula in the anterior wall. In histological examination, the tumor was diagnosed as mucinous well differentiated adenocarcinoma of the anal canal complicating Crohn's disease.

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