From fistula to malignancy: rectal mucinous adenocarcinoma arising in a chronic perianal fistula, a rare diagnostic challenge
Abstract
Perianal fistula is a common surgical complaint that general surgeon frequently face in daily clinical practice. However, an adenocarcinoma arising from a fistula is an uncommon entity that has the propensity to mimic benign conditions leading to a delays in diagnosis and management. We present a case of a 42-year-old patient with long standing history of perianal fistula. Given the prolonged nature of his disease further investigations were warranted. While colonoscopy ruled out luminal disease, pelvic magnetic resonance imaging and deep tissue biopsies confirmed the diagnosis of invasive adenocarcinoma with focal mucinous component. The patient required neoadjuvant treatment followed by extra levator abdominoperineal excision and pelvic floor reconstruction. At 5-year follow up, the patient didn’t have local recurrence or distant metastasis.
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BibTeX
@article{almuhsin2026from,
title = {{From fistula to malignancy: rectal mucinous adenocarcinoma arising in a chronic perianal fistula, a rare diagnostic challenge}},
author = {Ahmed M AlMuhsin and Mohammed Tahtouh and Faisal Al Rashid and Zainab I Alruwaii and Abdulraheem Alshangiti and Fajer Bosaid},
journal = {Journal of surgical case reports},
year = {2026},
month = oct,
doi = {10.1093/jscr/rjag1003},
url = {https://europepmc.org/article/PMC/PMC13723266},
note = {CC BY},
}
RIS
TY - JOUR
TI - From fistula to malignancy: rectal mucinous adenocarcinoma arising in a chronic perianal fistula, a rare diagnostic challenge
AU - Ahmed M AlMuhsin
AU - Mohammed Tahtouh
AU - Faisal Al Rashid
AU - Zainab I Alruwaii
AU - Abdulraheem Alshangiti
AU - Fajer Bosaid
PY - 2026
DA - 2026/10/01
JO - Journal of surgical case reports
DO - 10.1093/jscr/rjag1003
UR - https://europepmc.org/article/PMC/PMC13723266
AB - Perianal fistula is a common surgical complaint that general surgeon frequently face in daily clinical practice. However, an adenocarcinoma arising from a fistula is an uncommon entity that has the propensity to mimic benign conditions leading to a delays in diagnosis and management. We present a case of a 42-year-old patient with long standing history of perianal fistula. Given the prolonged nature of his disease further investigations were warranted. While colonoscopy ruled out luminal disease, pelvic magnetic resonance imaging and deep tissue biopsies confirmed the diagnosis of invasive adenocarcinoma with focal mucinous component. The patient required neoadjuvant treatment followed by extra levator abdominoperineal excision and pelvic floor reconstruction. At 5-year follow up, the patient didn’t have local recurrence or distant metastasis.
SN - 2042-8812
ER -