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Mucinous Adenocarcinoma Arising from Fistula in Ano: MRI Findings

Yukihiro Hama1, Kohzoh Makita2, Tetsuo Yamana3 and Keiichi Dodanuki4

1 Department of Radiology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-0042, Japan.
2 Department of Radiology, Tokyo-kita Social Insurance Hospital, Tokyo, Japan.
3 Coloproctology Center, Social Insurance Chuo General Hospital, Tokyo, Japan.
4 Department of Radiology, Social Insurance Chuo General Hospital, Tokyo, Japan.


Figure 1
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  		Fig. 1A —51-year-old man with mucinous adenocarcinoma arising from fistula in ano. Sagittal T2-weighted fast spin-echo MR image (TR/TE, 4,020/118; echo-train length, 15; 300 x 300 mm field of view; 512 x 512 matrix; 8-mm section thickness; 1.6-mm intersection gap) shows markedly hyperintense heterogeneous content (arrows) within mass.

 

Figure 2
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  		Fig. 1B —51-year-old man with mucinous adenocarcinoma arising from fistula in ano. Sagittal fat-suppressed contrast-enhanced T1-weighted MR image (873/8.4; 300 x 300 mm field of view; 512 x 512 matrix; 6.5-mm section thickness; 1.3-mm intersection gap) shows several enhancing solid components (white arrows) and linear and papillary meshlike enhancing areas (arrowheads).

 

Figure 3
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  		Fig. 1C —51-year-old man with mucinous adenocarcinoma arising from fistula in ano. Coronal fat-suppressed contrast-enhanced T1-weighted MR image (930/10; 350 x 350 mm field of view; 256 x 256 matrix; 7-mm section thickness; 1.4-mm intersection gap) shows meshlike enhancing areas (arrowheads) and lymphadenopathy of left internal iliac node (white arrow). Severe stenosis of rectum (black arrow) is evident.

 

Figure 4
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  		Fig. 2 —67-year-old man with mucinous adenocarcinoma arising from fistula in ano. Axial T2-weighted fast spin-echo MR image (TR/TE, 5,760/106; echo-train length, 15; 330 x 330 mm field of view; 512 x 512 matrix; 7-mm section thickness; 1.4-mm intersection gap) shows markedly hyperintense mucin pool (arrow) without thick fibrous capsule. Thick fibrous capsule of fistula in ano (arrowhead) can be identified where there is no carcinoma.

 

Figure 5
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  		Fig. 3 —55-year-old man with mucinous adenocarcinoma arising from fistula in ano. Coronal fat-suppressed contrast-enhanced T1-weighted MR image (TR/TE, 930/10; 350 x 350 mm field of view; 256 x 256 matrix; 7-mm section thickness; 1.4-mm intersection gap) shows contrast enhancement of peritumoral adipose tissues (arrows).

 

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