A CASE OF FISTULA CANCER ASSOCIATED WITH PAGETOID SPREAD

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 63; no. 7; pp. 1760 - 1763
• Main Authors: OKUMURA, Kenji, SHIOAKI, Yasuhiro, KAN, Keitarou, MUTO, Fumitaka, KURIOKA, Hideaki, HOSOKAWA, Youhei
• Format: Journal Article
• Language: English
• Published: Japan Surgical Association 25.07.2002
• Subjects: mapping; pagetoid spread
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.63.1760

A 77-year-old woman was seen at the hospital because of anal pain and induration. She had been pointed out a fistula-in-ano at elsewhere, but she let it alone for about 6 years. When a resection of the fistula was performed under lumber anesthesia, we found mucoid tissue in the fistula. The frozen histological findings indicated that it was mucinous carcinoma, and so further operation was needed. Abdominoperineal resection of the rectum with D21 ymphadenectomy was performed. Histologically Paget's cells were seen in the edge of the skin resected. After a mapping was made at the department of dermatology, a curative resection of the skin with fat tissue under the skin was performed. No signs of recurrence have been detected for 19 months since the third operation. Particular attention should be paid to probable association of malignancy in the treatment of fistulain-ano with chronic inflammation. Mapping is very beneficial to assess the spread of perianal Paget's disease.