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Perianal Inflammation or Something More?

Romina Geraldine Dsouza1, Mohamed Rizwan Haroon Al Rasheed2, Gavin Low1

  • 1Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.

Journal of Clinical Imaging Science
|September 13, 2021
PubMed

Insights

Atypical imaging findings in perianal fistulae can indicate malignancy, not just infection. Early detection through tissue sampling is crucial for appropriate surgical management and better patient outcomes.

Area of Science:

  • Gastroenterology
  • Radiology
  • Oncology

Background:

  • Perianal fistulae often present with abscesses and ramifications, exhibiting typical imaging characteristics.
  • Chronic or recurrent fistulae may show atypical imaging findings, including solid, enhancing mass-like lesions without fluid.

Observation:

  • These atypical lesions can represent inflammatory masses or, less commonly, locally aggressive malignancy.
  • Distinguishing between inflammatory and malignant etiologies is critical for patient prognosis.

Findings:

  • Malignancy associated with perianal fistulae portends a poorer prognosis.
  • Prompt tissue sampling is recommended to exclude malignancy in cases of atypical findings.

Implications:

  • Accurate identification of atypical perianal fistula imaging is essential for radiologists.
  • The diagnosis directly influences surgical management strategies, impacting the potential for curative outcomes.
Keywords:
Carcinoma in fistula in anoPerianal fistulaPerianal mucinous adenocarcinomaPerianal phlegmon

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