Successful Treatment of Double Malignant Fistulas in Advanced Rectosigmoid Junction Tumor with Neoadjuvant Chemoradiation and Surgery: A Case Report

Abstract

This case report describes a successful treatment of rare double malignant fistulas in an advanced rectosigmoid junction tumor using neoadjuvant chemoradiation and surgery. An 81-year-old woman presented with poor appetite, abdominal fullness, dizziness, and bloody stool. She was diagnosed with an advanced rectosigmoid junction tumor with double malignant fistulas (ceco-sigmoid and ileo-sigmoid fistulas). The patient received neoadjuvant chemoradiation therapy followed by surgical resection of the tumor and the fistulas. The patient’s postoperative recovery was uneventful. Her pathological examination showed a partial pathological response to the neoadjuvant therapy. The patient had no evidence of local recurrence or distant metastasis at her 1-year follow-up. This case demonstrates the importance of a multidisciplinary approach in managing complex cases and suggests that neoadjuvant chemoradiation therapy combined with surgery may be an effective treatment for advanced rectosigmoid junction tumors with double malignant fistulas.