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Case Reports in Surgery
Volume 2014, Article ID 386150, 5 pages
Case Report

Mucinous Adenocarcinoma Arising in Chronic Perianal Fistula: Good Results with Neoadjuvant Chemoradiotherapy Followed by Surgery

1Departamento de Cirurgia, Serviço de Cirurgia Digestiva, Hospital de Santo António, Largo Professor Abel Salazar, 4099-003 Porto, Portugal
2Departamento de Patologia, Serviço de Anatomia Patológica, Hospital de Santo António, Largo Professor Abel Salazar, 4099-003 Porto, Portugal
3Departamento de Patologia e Imunologia Molecular, Instituto de Ciências Biomédicas Abel Salazar, Rua Jorge Viterbo Ferreira No. 228, 4050-313 Porto, Portugal

Received 19 September 2014; Accepted 20 October 2014; Published 18 November 2014

Academic Editor: Alexander R. Novotny

Copyright © 2014 Marisa D. Santos et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Chronic perianal fistulas are a common clinical condition. However, their evolution to adenocarcinoma is rare. We report the case of a 48-year-old man with perianal chronic fistulas, who developed two perianal ulcerated lesions near the external orifices of the fistulas, which extended proximally as a pararectal tumor. No intestinal lesion was seen at endoscopic examination. Histopathological biopsy indicated mucinous adenocarcinoma. Staging was performed by pelvic magnetic resonance imaging (MRI) and thoracoabdominal CT scan. The patient underwent a laparoscopic colostomy followed by neoadjuvant chemoradiotherapy and then laparoscopic abdominoperineal resection followed by adjuvant therapy. We have seen a favorable outcome with no recurrence at 3 years of follow-up.