Implantation metastasis from adenocarcinoma of sigmoid colon into fistula in ano.

Abstract

D J Thomas and M R Thompson (June 1992 JRSM, p 361) could only find one report of implantation metastasis from a colonic carcinoma into a fistula in ano, but their search must have been of limited extent. In a paper on Implantation from the bowel lumen in cancer of the large intestine in 19611, I reviewed the then literature, and found a fair number of reports of what might be called 'natural' implants from the lumen ofthe bowel, as well as nine examples of superficial implants in the anal canal from carcinomas more proximally at St Mark's Hospital. The reports were ofimplants after injection of piles, after abscesses and long standing fistulas at the anus, and in haemorrhoidectomy wounds25. I was searching for clinical evidence for the occurrence of implantation, in assessing the use ofmercuric chloride solution at St Mark's Hospital to eliminate implantation at the suture line following resection of a carcinoma of the colon and rectum. MILO KEYNES 3 Brunswick Walk, Cambridge CB5 8DH