粘膜下腫よう様病変を伴った痔ろう癌の１例

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  • A CASE OF ANAL FISTULA CANCER WITH A SUBMUCOSAL TUMOR

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A 54-year-old man was admitted to the hospital because of persisting colloidal discharge from the anus and perianal induration left after a radical aperation for anal fistula. He had been afflicted with fistula ani for 42 years. Cancer of the anal fistula was diagnosed preoperatively. A 3×2 cm tumor was present in the direction of six o'clock of the anus. Histological examination of the removed material from the fistula suggested adenocarcinoma. Preoperative colonofiberscopy showed a submucosal tumor 1 cm in diameter located oral to the primary opening.<br>The tumor was diagnosed as submucosal cyst (mucus lake) communicated with the anal fistula based on pathological exploration of the excised material. It was etiologically thought that the cyst was formed via fistulization extended from the primary opening to the oral side. Cancer arisen in an anal fistula is thought to show extraluminal spread, and there have been no cases of anal fistula cancer with intraluminal spread to form mucus lake in a form of a submucosal cyst like in this case. This case which showed a quite rare extension is presented here.

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