Mucinous-Type Adenocarcinoma Arising from a Chronic anal Fistula: About 4 Cases

Le résumé fourni par la source

Perianal mucinous adenocarcinoma is a rare and aggressive tumor, most often arising from chronic anal fistulas, which makes early diagnosis difficult due to nonspecific symptoms. Objective: To report, through clinical cases, the clinical, therapeutic, and outcome aspects of mucinous adenocarcinoma developing on chronic anal fistulas. Materials and methods: A retrospective study conducted over a 3-year period (June 2022 to May 2025), including patients with mucinous adenocarcinoma arising from an anal fistula confirmed by biopsy. Results: Four patients with a mean age of 46.8 years presented with an anal fistula with a mean disease duration of 11.3 years. MRI revealed perianal tumor masses in continuity with the fistulous tracts. Histological examination of the fistulous tracts confirmed mucinous adenocarcinoma. All patients underwent a diverting colostomy followed by neoadjuvant chemoradiotherapy. The outcome was unfavorable in two cases, with early death, highlighting the aggressive nature and poor prognosis of this disease. Conclusion: Mucinous perianal adenocarcinoma is aggressive and often diagnosed late. This condition should be suspected in cases of chronic fistula. Treatment must be multidisciplinary.

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