Table of Contents Author Guidelines Submit a Manuscript
Case Reports in Surgery
Volume 2017 (2017), Article ID 1929182, 4 pages
https://doi.org/10.1155/2017/1929182
Case Report

Squamous Cell Carcinoma Originating from a Crohn’s Enterocutaneous Fistula

1University of Louisville Division of Colon and Rectal Surgery, Louisville, KY, USA
2Geisinger Health System, Danville, PA, USA
3University of Louisville School of Medicine, Louisville, KY, USA

Correspondence should be addressed to Bogdan Protyniak; moc.liamg@kainytorp

Received 17 December 2016; Revised 3 March 2017; Accepted 28 March 2017; Published 9 April 2017

Academic Editor: Imran Hassan

Copyright © 2017 Bogdan Protyniak 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.

Abstract

Purpose. Squamous cell carcinoma (SCC) developing within fistulae and chronic wounds in patients with Crohn’s disease is a rare phenomenon with few reported studies in the literature. Clinical suspicion for SCC in Crohn’s disease patients with chronic painful fistulae is low, leading to delayed diagnosis and treatment. We present a patient with long-standing Crohn’s disease complicated by malignant degeneration of an enterocutaneous fistula tract. Methods. Workup with MRI, CT, and fistulogram revealed a 7 × 3 cm fistulous connection between a loop of small intestine and the patient’s perineum. Biopsies of the fistula tract confirmed the diagnosis of SCC. Results. The patient underwent an abdominoperineal resection with positive margins and is currently awaiting radiation therapy. Conclusions. This is the second case reported within the English literature of SCC arising from an enterocutaneous fistula in the setting of Crohn’s disease. Based on the findings in this case report and others presented in the literature, a high degree of suspicion of malignancy should be present in patients with chronic painful, poor-healing fistulae, especially in the absence of infection.