Mucinous Adenocarcinoma Arising from Chronic Perianal Fistula - A Case report

Abstract

Mucinous adenocarcinoma arising from chronic perianal fistula in ano is a rare entity [1]. It is often mismanaged as benign disease due to its presentation. At present no guidelines have been established concerning diagnostic and treatment strategies due to the rarity of the tumour [2].A high index of clinical suspicion and biopsy of fistulous tracts and abscesses are key to early diagnosis and prompt treatment. We present a case of a 45 years old gentleman who initially presented with history of chronic perianal fistula for 3 years. Several biopsies from the fistulous tract, perianal skin opening and sigmoidoscopy biopsy were suggestive of benign nature of the disease. In view of high index of clinical suspicion and the nonhealing nature of the fistula tract, he underwent abdominal perineal resection with pediculated gracilis myocutaneous flap. The final histopathology report confirmed perianal mucinous adenocarcinoma.