Perianal mucinous adenocarcinoma. Another reason for deep biopsy when dealing with anal fistulas or abscesses

A 39-year-old man came to us for surgical treatment of a hidradenitis suppu rativa. Upon excision of a perianal abscess, the diagnosis of a rare tumor; a perianal mucinous adenocarcinoma (pT4, pN 1, MO), was made. An abdominop erineal resection was performed, followed by a combination of adjuvant radi ation and chemotherapy. A year after the operation, the patient is doing we ll without any signs of recurrence. This carcinoma probably arises in the a nal glands. It often presents as a perirectal abscess and/or an anal fistul a. Therefore, the diagnosis is often delayed. At presentation, the tumor is bigger than 5 cm in diameter in 80 % of the cases, and the prognosis is po or. It metastasizes mostly to the superficial inguinal or to the retrorecta l lymph nodes. There are only ease reports and no comparative studies in th e literature. In the last 10 years, the carcinoma has mostly been treated b y neoadjuvant radiation and chemotherapy, followed by abdominoperineal rese ction. Since then, the median survival has increased to 3 years. This is th e first case report of a combination. of a perianal mucinous adenocarcinoma with a hidradenitis suppurativa.