CASE REPORT article
Front. Oncol.
Sec. Gastrointestinal Cancers: Colorectal Cancer
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1673829
Case Report of Squamous Cell Carcinoma Secondary to Recurrent Anal Fistula
Provisionally accepted
- 1南京市中医院, 江苏省南京市, China
- 2Nanjing University of Chinese Medicine, Nanjing, China
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Anal fistula is a common benign perianal condition, and its malignant transformation, particularly into squamous cell carcinoma, is rare and often associated with comorbidities such as Crohn's disease and HIV infection. This article reports the case of a 66-year-old male with a history of recurrent anal fistula spanning more than 10 years who underwent 3 surgical treatments. Pathological findings from the first two surgeries showed no malignant lesions, while the third confirmed moderately to poorly differentiated squamous cell carcinoma. The patient had a history of lymphoma and small bowel resection; HIV infection was excluded upon admission. Carcinoembryonic antigen and cytokeratin 19 fragment levels were mildly elevated, and imaging revealed a high complex anal fistula. The diagnosis was ultimately confirmed by pathological biopsy. We propose that malignant transformation may be linked to chronic inflammatory stimulation, reduced immune function, and prior abdominal surgery. Diagnosis depends on pathological confirmation, and the use of multiple imaging modalities can improve diagnostic accuracy. The uniqueness of this case lies in the non-continuous recurrence of the anal fistula, offering a new perspective on the clinical characteristics of anal fistula carcinogenesis.
Keywords: anal fistula, malignant transformation, Squamous cell carcinoma, case, secondary
Received: 26 Jul 2025; Accepted: 12 Sep 2025.
Copyright: © 2025 Zhu, Zhang, Liu, Ye, Huang and Xue. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ya- Hong Xue, 南京市中医院, 江苏省南京市, China
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