부산대학교 도서관

The patient was a 59-year-old man who was admitted to our hospital complaining of fever and anal pain. A secondary orifice scar was detected in the 9 o’clock position and a perirectal abscess in the 7 o’clock position. After incision and drainage of the abscess in the 7 o’clock position, a draining Seton was placed. Subsequently, fistula resection in the 7 o’clock position was performed, and another draining Seton was placed. After 8 months, the lesions had resolved completely. However, subsequently, 7 months later, the abscess recurred in the 7 o’clock position, and incision and drainage was performed, which revealed mucus-like pus and an underlying mass. The mass was diagnosed as adenocarcinoma by biopsy. Computed tomography and magnetic resonance imaging revealed a multilocular cystoid tumor at the same site, and laparoscopic abdominoperineal resection was performed. Histopathological examination confirmed the tumor as an adenocarcinoma, mainly consisting of mucinous adenocarcinoma, spreading through adipose tissue and muscle tissue. The cancer was considered to have arisen from the anal fistula. The patient has shown no evidence of recurrence until date, 2 years after the operation. Our results indicate that patients who undergo Seton treatment for anal fistula require careful follow-up for cancer development.