Abstract
The development of cancer at the site of a chronic fistula in the absence of Crohn’s disease (CD) is very rare. However, also in long-standing CD complicated by chronic sinuses or fistulas, the occurrence of carcinoma related to the fistula is seldom, with an incidence of less than 0.7% of CD patients [1]. A review of 40 cases of anorectal carcinomas in patients with fistulizing CD showed that only in 22 (55%) patients could a definite association with an anorectal fistula be established. These cancers were classified as squamous cell carcinomas (10), adenocarcinomas (11), and basaloid carcinoma (1) [1]. The tumors presented several years (range 14–20 years) after the initial diagnosis of CD [1, 2]. Although the causative relationship between CD and the carcinomatous transformation of anorectal fistulas is not fully understood, it has been suggested that delayed wound healing, constant mucosal regeneration and high cell turnover rates, and the immunosuppressive therapies used to treat CD all play a role [3, 4].
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Maconi, G., Furfaro, F., Bezzio, C. (2013). Cancer in Perianal Fistulas. In: Tonolini, M., Maconi, G. (eds) Imaging of Perianal Inflammatory Diseases. Springer, Milano. https://doi.org/10.1007/978-88-470-2847-0_15
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DOI: https://doi.org/10.1007/978-88-470-2847-0_15
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