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Carcinoma anal associado aos trajectos fistulosos da doença de Crohn
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Orientador(es)
Resumo(s)
As neoplasias malignas que surgem a partir das fístulas perianais associadas à D. Crohn são raras. No entanto, é uma patologia com mau prognóstico por ser diagnosticada tardiamente com doença avançada. Uma das principais questões é não haver guidelines de vigilância e tratamento.
O objectivo deste trabalho é indicar as características clínicas dos doentes do Hospital Santa Maria (HSM), que desenvolveram neoplasia perianal num trajecto fistuloso e compará-las com a literatura.
O diagnóstico dos nossos doentes foi tardio, sendo que a maioria obtiveram o diagnóstico por exame extemporâneo enquanto fizeram a ressecção abdomino-perineal com colostomia de derivação.
Por ser uma patologia rara, não existem guidelines de vigilância por ausência de estudos prospectivos significativos. No entanto, é uma doença diagnosticada tardiamente, com mau prognóstico e com impacto significativo na qualidade de vida dos doentes após o tratamento. Portanto apesar de ser uma patologia rara, é merecedora de uma atenção prospectiva para clarificar os procedimentos a efectuar.
Cancer arising from Chron's disease associated perianal fistulae is rare. Nevertheless, it has poor prognosis due to its late diagnosis. One of the main issues is that specific vigilance and treatment guidelines are non-existant. The aim of this final work is to refer the clinical aspects and characteristics of Hospital Santa Maria's patients who developed fistulae-associated perianal neoplasies and to compare them with the available literature. Our patients' diagnosis was late and most of them were made during the abdomino-perianal resection. Due to its rarity, there are no specific guidelines regarding vigilance since there are no significant prospective studies. This condition's late diagnosis and its poor prognosis negatively impact on the patients' post-treatment quality of life. Therefore, the main focus should reside on which procedures are to be performed.
Cancer arising from Chron's disease associated perianal fistulae is rare. Nevertheless, it has poor prognosis due to its late diagnosis. One of the main issues is that specific vigilance and treatment guidelines are non-existant. The aim of this final work is to refer the clinical aspects and characteristics of Hospital Santa Maria's patients who developed fistulae-associated perianal neoplasies and to compare them with the available literature. Our patients' diagnosis was late and most of them were made during the abdomino-perianal resection. Due to its rarity, there are no specific guidelines regarding vigilance since there are no significant prospective studies. This condition's late diagnosis and its poor prognosis negatively impact on the patients' post-treatment quality of life. Therefore, the main focus should reside on which procedures are to be performed.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2017
Palavras-chave
Doença de Crohn Doença fistulosa perianal Adenocarcinoma mucoso anal Carcinoma de células escamosas anal Coloproctologia