Perianal Mucous Adenocarcinoma Secondary to Chronic Anal Fistula: A Case Report and Literature Review

为了探讨肛瘘继发肛周黏液腺癌的诊断、治疗及预后，提高临床医务工作者对该疾病的认识，早期诊断，避免漏诊、误诊，降低远期并发症及死亡率，对昆明医科大学第二附属医院中医科收治的1例肛瘘继发肛周黏液腺癌病例进行分析并回顾性总结文献报道的相关诊治经验，发现肛瘘癌变病程进展缓慢，在病变早期通常无排便习惯改变及直肠刺激症状，缺乏特征性的临床表现，致使该病误诊、漏诊率高，确诊需依靠瘘管及相关肿物的病理学活检。因此对于长期不愈的肛瘘应警惕恶变的可能，及时完善组织病理学检查有助于早期诊断和治疗，提高患者预后。In order to explore the diagnosis, treatment and prognosis of perianal mucinous adenocarcinoma secondary to anal fistula, improve the understanding of clinical staff on this disease, make early diagnosis, avoid missed diagnosis and misdiagnosis, and reduce long-term complications and mortality, a case of perianal mucinous adenocarcinoma secondary to anal fistula admitted to Department of Traditional Chinese Medicine, The Second Affiliated Hospital of Kunming Medical University, was analyzed and the relevant diagnosis and treatment experience reported in the literature was retrospectively summarized. It was found that the course of anal fistula cancer progressed slowly, there were usually no bowel habit changes and rectal irritation symptoms in the early stage of the disease, and the lack of characteristic clinical manifestations led to a high rate of misdiagnosis and missed diagnosis of the disease, and the diagnosis was determined by pathological biopsy of fistulas and related tumors. Therefore, the possibility of malignant transformation should be vigilant for the long-term unhealed anal fistula, and timely improvement of histopathological examination is conducive to early diagnosis and treatment, and improve the prognosis of patients.