Cancer in perianal fistulas

The presence of a perianal fistula as a complication related to Crohn's disease (CD) was first described by Penner and by Burrill Crohn himself in 1938 [1]. Since then, intense efforts have been made and significant economic resources spent in order to improve the quality of life of patients with inflammatory bowel diseases (IBDs) who also have perianal fistulas. Unfortunately, the results have been poor regardless of the medical or surgical treatment adopted. The incidence of perianal disease is 20-25% in CD patients with terminal ileitis, but it increases to as high as 60% in CD with a colonic location and 92% when the rectum is actively involved [2-4]. In ulcerative colitis (UC) perianal suppurative lesions are less common, but the incidence of perianal abscesses and fistulas is still reported to be between 10% and 15% [5].