Author/Authors :
Weifeng, Lao Zhejiang University School of Medicine - Sir Run Run Shaw Institute of Clinical Medicine,Sir Run Run Shaw Hospital - Department of Colorectal Surgery, China , Jing, Deng Zhejiang Medical College - Department of Clinical Medicine, China , Sameer, Memon Peter MacCallum Cancer Centre - Department of Cancer Surgery, Australia , Weifang, Mao Zhejiang University School of Medicine - Sir Run Run Shaw Institute of Clinical Medicine,Sir Run Run Shaw Hospital - Department of Colorectal Surgery, China , Chao, He Zhejiang University School of Medicine - Sir Run Run Shaw Institute of Clinical Medicine,Sir Run Run Shaw Hospital - Department of Colorectal Surgery, China
Abstract :
Implantation metastasis of colorectal cancer in an anal fistula is very rare. We report a case of a 61 years old male who underwent fistulectomy for an anal fistula. Histopathology unexpectedly revealed adenocarcinoma in the fistula track, however the patient refused further treatment. Sixteen months later he presented with an obstructing locally advanced rectosigmoid cancer found to be fixed into the pelvic wall. An ileosigmoid bypass was fashioned and he was treated with neoadjuvant chemoradiotherapy followed by high anterior resection. Histopathology confirmed a colorectal adenocarcinoma, Immunohistochemistry of the tumors from both sites was CK7-/CK20+. The patient died 34 months later with liver and lung metastasis however no perianal recurrence occurred. Local resection with or without radiotherapy, instead of abdominoperineal resection, was feasible for control of perianal metastatic lesion implanted from colorectal cancer if local extended resection was possible.
