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Related Experiment Videos

Leukaemia-in-ano.

Edmund Leung1, Ling Wong2

  • 1Base Hospital, New Plymouth.

The New Zealand Medical Journal
|September 30, 2020
PubMed
Summary
This summary is machine-generated.

Fistula-in-ano, a common surgical issue, can rarely be caused by chronic lymphocytic leukemia (CLL) infiltration. This case highlights successful joint medical and surgical treatment for this unusual presentation.

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Area of Science:

  • Gastroenterology
  • Oncology
  • Surgical Pathology

Background:

  • Fistula-in-ano is a prevalent surgical condition often stemming from anal cryptoglandular inflammation, typically idiopathic.
  • While common causes include Crohn's disease, trauma, and malignancy, management focuses on surgical drainage and fistula eradication while preserving continence.
  • Identifying the underlying etiology is critical for appropriate management, especially when combined medical therapy is needed, as in Crohn's disease.

Observation:

  • A rare case of fistula-in-ano in an elderly male patient with a history of chronic lymphocytic leukemia (CLL) is presented.
  • Histological examination of the fistula track revealed direct infiltration by CLL cells.
  • This specific presentation of fistula-in-ano secondary to CLL infiltration has not been previously documented in PubMed.

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Findings:

  • The fistula-in-ano was successfully treated through a collaborative approach involving surgical intervention and specialist hematological management.
  • The successful outcome underscores the importance of considering hematological malignancies as a potential, albeit rare, cause of complex anal fistulas.
  • Histological confirmation of CLL infiltration in the fistula tract provides direct evidence of the etiological link.

Implications:

  • This case broadens the differential diagnosis for complex or recurrent fistula-in-ano, suggesting the inclusion of hematological malignancies.
  • It emphasizes the necessity of a multidisciplinary approach, integrating surgical and oncological expertise for optimal patient outcomes in rare presentations.
  • Further research may be warranted to understand the pathogenesis and optimal management strategies for malignancy-associated fistula-in-ano.