Abstract
An 88-year-old man had multiple anal fistula left untreated for 20 years. Recently, bloody mucous disharge was observed from anal fistula, and was admitted to the hospital for operation of the anal fistula. External openings were located in the direction of 1, 3 and 5 O'clock. Cytologic examination of mucous bloody discharge was performed, but no malignant findings was obtained. An operation for anal fistula was performed, but a possibility of fistula cancer could not be ruled out. Intraoperative histological examination of wall of the anal fistula indicated adenocarcinoma. Abdomono-perineal resection was carried out under the diagnosis of fistula cancer. Histopathologically, it was mucin producting well differentiated adenocarcinoma with papillary structure which was localized within surface of the fistula. It was comparatively early fistula cancer without muscular invasion. This case will suggest fistula cancer may arise from wall of fistula. This type of early stage of fistula cancer has been reported in only 3 cases in our country.
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