title: Rectosigmoid adenocarcinoma revealed by metastatic anal fistula. The visible part of the iceberg: a report of two cases with literature review.
abstract: Colonic adenocarcinoma revealed by metastatic anorectal fistula is rare, with few cases in the literature. Such lesions can be taken for the more common manifestation of a benign perianal abscess or fistula. Once diagnosed, the management of such conditions remains controversial. We herein report two cases with perianal fistula that were subsequently found to have developed perianal adenocarcinoma on biopsy. Further colonic investigation revealed a rectosigmoid adenocarcinoma. Histology and immunohistochemical staining was identical in both primary and metastatic tumors. Preoperative chemoradiation with further rectal low anterior resection and local excision of metastatic anal fistula was performed. There is no recurrence after 3 years of follow-up.
authors.affiliation: Department of Surgery, University Hospital Hassan II, Fez 30000, Morocco. benjelloun19@hotmail.com
authors.forename: El Bachir
authors.initials: el B
authors.lastname: Benjelloun
authors.forename: Said
authors.initials: S
authors.lastname: Aitalalim
authors.forename: Leila
authors.initials: L
authors.lastname: Chbani
authors.forename: Ihsan
authors.initials: I
authors.lastname: Mellouki
authors.forename: Khalid
authors.initials: K
authors.lastname: Mazaz
authors.forename: Kahlid
authors.initials: K
authors.lastname: Aittaleb
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary*; D000368:Aged; D001005:Anus Neoplasms / Q000556:secondary* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012003:Rectal Fistula / Q000473:pathology*; D012811:Sigmoid Neoplasms / Q000473:pathology*