Case report: late perianal mucinous adenocarcinoma after Crohn's disease proctectomy: an oncological rarity.
BACKGROUND
As in ulcerative colitis, there is an increased incidence of colorectal carcinoma in Crohn's disease. While carcinoma formation originating from ano-rectal fistulas is generally considered as a rare event there are different publications reporting on mucinous adenocarcinoma formation in association with a neovagina and rectovaginal fistulas. To the best of our knowledge this is the first description of a perianal mucinous adenocarcinoma arising in a patient after Crohn's disease proctocolectomy.


METHODS
We report the case of a 50-year old female with a mucinous adenocarcinoma forming in the perineum eleven years after proctocolectomy for Crohn's disease. The patient was readmitted with perineal pain, leucocytosis and a perineal mass highly suspicious of abscess formation in the MRI-Scan. Histological examination revealed a mucinous adenocarcinoma. Exenteration including vagina, uterus and ovaries together with the coccygeal-bone was performed.


CONCLUSIONS
Mucinous adenocarcinoma formation is a rare complication of Crohn's disease and so far unreported after proctocolectomy.
Keese
Michael
M
Department of Surgery, University Hospital of Mannheim, 68135 Mannheim, Germany. michael.keese@chir.ma.uni-heidelberg.de
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Walter
W
Dinter
Dietmar
D
Gladisch
Rainer
R
Joos
Andreas
A
Palma
Pablo
P