Synchronous mucinous adenocarcinoma of the recto sigmoid rev
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Synchronous rectosigmoid mucinous adenocarcinoma seeding an anal fistula is a very rare condition. Diagnosis is difficult especially when primary tumor remains unknown and the chronic lesion of anal fistula seems to be a benign condition. The management of these cases remain controversial. We present a rare case of the chronic anal fistula with the presence of a reccurent perianal abscess with synchronous rectosigmoid mucinous adenocarcinoma. A persistent anal fistula with recurrent inflammation is known to lead to primary cancer, and such cancer develops in 0,1% of all anal fistulae.. The histological exam revealed mucinous adenocarcinoma in two sites, representing two tumors, cells were immunopositive for cytokeratin 20 and negative in cytokeratin 7. The patient underwent “laparoscopic extralevator abdominoperineal excision ” with both lesions being resected. There is no recurrence after four years of follow-up. This case highlights the importance of further investigation and the need of biopsy in anal fistulae...

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