Squamous Cell Carcinoma Originating from a Crohn’s Enterocutaneous Fistula

Purpose. Squamous cell carcinoma (SCC) developing within fistulae and chronic wounds in patients with Crohn’s disease is a rare phenomenon with few reported studies in the literature. Clinical suspicion for SCC in Crohn’s disease patients with chronic painful fistulae is low, leading to delayed diag...

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Main Authors: Bogdan Protyniak, Travis Shutt, Russell Farmer
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Case Reports in Surgery
Online Access:http://dx.doi.org/10.1155/2017/1929182
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author Bogdan Protyniak
Travis Shutt
Russell Farmer
author_facet Bogdan Protyniak
Travis Shutt
Russell Farmer
author_sort Bogdan Protyniak
collection DOAJ
description Purpose. Squamous cell carcinoma (SCC) developing within fistulae and chronic wounds in patients with Crohn’s disease is a rare phenomenon with few reported studies in the literature. Clinical suspicion for SCC in Crohn’s disease patients with chronic painful fistulae is low, leading to delayed diagnosis and treatment. We present a patient with long-standing Crohn’s disease complicated by malignant degeneration of an enterocutaneous fistula tract. Methods. Workup with MRI, CT, and fistulogram revealed a 7 × 3 cm fistulous connection between a loop of small intestine and the patient’s perineum. Biopsies of the fistula tract confirmed the diagnosis of SCC. Results. The patient underwent an abdominoperineal resection with positive margins and is currently awaiting radiation therapy. Conclusions. This is the second case reported within the English literature of SCC arising from an enterocutaneous fistula in the setting of Crohn’s disease. Based on the findings in this case report and others presented in the literature, a high degree of suspicion of malignancy should be present in patients with chronic painful, poor-healing fistulae, especially in the absence of infection.
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spelling doaj-art-531d670a7d834f1dbdd8d4e43b6b12c22025-08-20T03:36:34ZengWileyCase Reports in Surgery2090-69002090-69192017-01-01201710.1155/2017/19291821929182Squamous Cell Carcinoma Originating from a Crohn’s Enterocutaneous FistulaBogdan Protyniak0Travis Shutt1Russell Farmer2University of Louisville Division of Colon and Rectal Surgery, Louisville, KY, USAUniversity of Louisville Division of Colon and Rectal Surgery, Louisville, KY, USAUniversity of Louisville Division of Colon and Rectal Surgery, Louisville, KY, USAPurpose. Squamous cell carcinoma (SCC) developing within fistulae and chronic wounds in patients with Crohn’s disease is a rare phenomenon with few reported studies in the literature. Clinical suspicion for SCC in Crohn’s disease patients with chronic painful fistulae is low, leading to delayed diagnosis and treatment. We present a patient with long-standing Crohn’s disease complicated by malignant degeneration of an enterocutaneous fistula tract. Methods. Workup with MRI, CT, and fistulogram revealed a 7 × 3 cm fistulous connection between a loop of small intestine and the patient’s perineum. Biopsies of the fistula tract confirmed the diagnosis of SCC. Results. The patient underwent an abdominoperineal resection with positive margins and is currently awaiting radiation therapy. Conclusions. This is the second case reported within the English literature of SCC arising from an enterocutaneous fistula in the setting of Crohn’s disease. Based on the findings in this case report and others presented in the literature, a high degree of suspicion of malignancy should be present in patients with chronic painful, poor-healing fistulae, especially in the absence of infection.http://dx.doi.org/10.1155/2017/1929182
spellingShingle Bogdan Protyniak
Travis Shutt
Russell Farmer
Squamous Cell Carcinoma Originating from a Crohn’s Enterocutaneous Fistula
Case Reports in Surgery
title Squamous Cell Carcinoma Originating from a Crohn’s Enterocutaneous Fistula
title_full Squamous Cell Carcinoma Originating from a Crohn’s Enterocutaneous Fistula
title_fullStr Squamous Cell Carcinoma Originating from a Crohn’s Enterocutaneous Fistula
title_full_unstemmed Squamous Cell Carcinoma Originating from a Crohn’s Enterocutaneous Fistula
title_short Squamous Cell Carcinoma Originating from a Crohn’s Enterocutaneous Fistula
title_sort squamous cell carcinoma originating from a crohn s enterocutaneous fistula
url http://dx.doi.org/10.1155/2017/1929182
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