Squamous Cell Carcinoma Arising from Perianal Fistula in HIV Positive Patient

Oncology, Gastroenterology and Hepatology Reports ,2018,7,2,98-101.
Published:November 2018
Type:Case Report
Author(s) affiliations:

Pedro Silva1,*, Rita Vitorino2, Catarina Travancinha1, João Freire2

1Department of Radiotherapy, Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E.. PORTUGAL 

2Department of Medical Oncology – Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E., PORTUGAL 


Anal carcinomas account for 1-2% of all digestive tract cancers. They may occur in the anal canal, perianal region (up to 5cm) and surrounding skin. Squamous cell carcinoma (SCC) is the most frequent type (80%). In the last decades, the incidence of anal SCC has increased in relation with the human immunodeficiency virus (HIV) infection, especially in men who have sex with men (MSM). Individuals with impaired immunity, such HIV positive, are at higher risk of perianal diseases, which has not been altered by the introduction of highly active antiretroviral therapy. SCC arising from a perianal fistula is rare. We report a rare case of a large squamous cell carcinoma arising from a perianal fistula, in a HIV positive patient, successfully treated with chemo-radiotherapy alone with no late toxicity. Long standing perianal fistula often causes late diagnosis of perianal carcinoma. A previous history of HIV positive may increase the index of suspicion for malignancy.

MRI scan 3-years post CRT treatment (axial view).