Case report of an anal adenocarcinoma arising from a perineal lump. (March 2016)

• Record Type: Journal Article
• Authors: Chan, Dedrick Kok-Hong; Chong, Choon-Seng; Tan, Ker-Kan
• Is Part Of: Annals of medicine and surgery. Volume 6(2016)
• Page Start: 23
• Page End: 25
• Publication Date: 2016-03
• Subjects: Perineal lump -- Chronic inflammation -- Anal adenocarcinoma; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2016.01.002
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Anal adenocarcinoma is a rare condition and can arise in chronic inflammatory states such as in Crohn's disease, or in a chronic fistula-in-ano. We report our diagnosis and management of a patient who presented with a large perineal lump with a long-standing history of perianal fistulous disease. This was initially evaluated with a Magnetic Resonance Imaging, and the diagnosis was confirmed with biopsy. Multimodality treatment with chemoradiotherapy and surgery should be offered to achieve the best outcomes. Highlights: Although anal adenocarcinoma is rare, it can arise from chronic inflammatory states such as long standing perianal fistulae. MRI can be helpful in delineating the underlying aetiology, but histology is ultimately required for definitive diagnosis. Radical surgery with either neoadjuvant or adjuvant chemoradiotherapy appears to be most effective.