{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:25:11Z","timestamp":1767140711916,"version":"build-2238731810"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2020,3,17]],"date-time":"2020-03-17T00:00:00Z","timestamp":1584403200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,3,17]],"date-time":"2020-03-17T00:00:00Z","timestamp":1584403200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Colorectal Dis"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Crohn\u2019s disease (CD) is a chronic inflammatory disorder which leads to anorectal fistulas. In rare cases, patients develop anal squamous cell carcinoma (ASCC) within these lesions. There is limited literature regarding ASCC in patients with CD. Here, we report on a unique case of advanced verrucous carcinoma (VC), a rare variant of squamous cell carcinoma, developing on the grounds of extensive chronic anorectal fistulas in CD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>A 54-year-old male patient with a 20-year history of CD presented with a large inflammatory tumor at the perineal region with multiple discharging perianal fistulas. Histopathological analysis of the perineal mass revealed a VC. Subsequent surgery with radical tumor resection and terminal colostomy resulted in a large perineal cavity and a partially exposed sacrum. The defect extended to a total of 35\u2009\u00d7\u200925\u2009\u00d7\u200925\u00a0cm. Reconstruction was achieved through a two-step approach. A first surgical step established an arteriovenous (AV) loop in the upper thigh. Subsequently, a free latissimus dorsi (LD) myocutaneous flap was harvested and anastomosed with the AV loop, allowing for satisfactory closure of the defect and reconstruction of the perianal and perineal region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Radical surgical excision with negative margins is the therapy of choice for VC. This case report demonstrates a curative treatment option with special emphasis on the reconstructive possibilities of a unique case of extended perianal and perineal VC associated with chronic anorectal fistulas in CD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00384-020-03569-z","type":"journal-article","created":{"date-parts":[[2020,3,17]],"date-time":"2020-03-17T00:49:36Z","timestamp":1584406176000},"page":"1337-1341","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Complex microsurgical perineal reconstruction after resection of a giant verrucous carcinoma associated with anal fistulas in Crohn\u2019s disease\u2014a unique case report"],"prefix":"10.1007","volume":"35","author":[{"given":"Denis","family":"Ehrl","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Rentsch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Moellhoff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolaus","family":"Wachtel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,3,17]]},"reference":[{"issue":"5","key":"3569_CR1","doi-asserted-by":"publisher","first-page":"1394","DOI":"10.3748\/wjg.v21.i5.1394","volume":"21","author":"M Marzo","year":"2015","unstructured":"Marzo M, Felice C, Pugliese D, Andrisani G, Mocci G, Armuzzi A, Guidi L (2015) Management of perianal fistulas in Crohn\u2019s disease: an up-to-date review. World J Gastroenterol 21(5):1394\u20131403. https:\/\/doi.org\/10.3748\/wjg.v21.i5.1394","journal-title":"World J Gastroenterol"},{"issue":"6","key":"3569_CR2","doi-asserted-by":"publisher","first-page":"e232","DOI":"10.1016\/j.crohns.2012.09.015","volume":"7","author":"B el Benjelloun","year":"2013","unstructured":"el Benjelloun B, Abkari M, Ousadden A, Ait Taleb K (2013) Squamous cell carcinoma associated anal fistulas in Crohn\u2019s disease unique case report with literature review. J Crohns Colitis 7(6):e232\u2013e235. https:\/\/doi.org\/10.1016\/j.crohns.2012.09.015","journal-title":"J Crohns Colitis"},{"issue":"4","key":"3569_CR3","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1007\/bf00341224","volume":"7","author":"S Nordgren","year":"1992","unstructured":"Nordgren S, Fasth S, Hulten L (1992) Anal fistulas in Crohn\u2019s disease: incidence and outcome of surgical treatment. Int J Color Dis 7(4):214\u2013218. https:\/\/doi.org\/10.1007\/bf00341224","journal-title":"Int J Color Dis"},{"issue":"8","key":"3569_CR4","doi-asserted-by":"publisher","first-page":"992","DOI":"10.1007\/bf02237388","volume":"41","author":"A Ky","year":"1998","unstructured":"Ky A, Sohn N, Weinstein MA, Korelitz BI (1998) Carcinoma arising in anorectal fistulas of Crohn\u2019s disease. Dis Colon Rectum 41(8):992\u2013996. https:\/\/doi.org\/10.1007\/bf02237388","journal-title":"Dis Colon Rectum"},{"issue":"5","key":"3569_CR5","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1007\/s00384-017-2794-8","volume":"32","author":"AL Lightner","year":"2017","unstructured":"Lightner AL, Moncrief SB, Smyrk TC, Pemberton JH, Haddock MG, Larson DW, Dozois EJ, Mathis KL (2017) Long-standing Crohn\u2019s disease and its implication on anal squamous cell cancer management. Int J Color Dis 32(5):661\u2013666. https:\/\/doi.org\/10.1007\/s00384-017-2794-8","journal-title":"Int J Color Dis"},{"key":"3569_CR6","doi-asserted-by":"publisher","first-page":"e148","DOI":"10.1038\/ctg.2016.8","volume":"7","author":"J Ruel","year":"2016","unstructured":"Ruel J, Ko HM, Roda G, Patil N, Zhang D, Jharap B, Harpaz N, Colombel JF (2016) Anal neoplasia in inflammatory bowel disease is associated with HPV and perianal disease. Clin Transl Gastroenterol 7:e148. https:\/\/doi.org\/10.1038\/ctg.2016.8","journal-title":"Clin Transl Gastroenterol"},{"issue":"2","key":"3569_CR7","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1054\/bjps.2000.3440","volume":"54","author":"E Vandeweyer","year":"2001","unstructured":"Vandeweyer E, Sales F, Deraemaecker R (2001) Cutaneous verrucous carcinoma. Br J Plast Surg 54(2):168\u2013170. https:\/\/doi.org\/10.1054\/bjps.2000.3440","journal-title":"Br J Plast Surg"},{"issue":"1","key":"3569_CR8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/0190-9622(95)90177-9","volume":"32","author":"RA Schwartz","year":"1995","unstructured":"Schwartz RA (1995) Verrucous carcinoma of the skin and mucosa. J Am Acad Dermatol 32(1):1\u201321; quiz 22-24. https:\/\/doi.org\/10.1016\/0190-9622(95)90177-9","journal-title":"J Am Acad Dermatol"},{"issue":"2","key":"3569_CR9","doi-asserted-by":"publisher","first-page":"182","DOI":"10.32471\/exp-oncology.2312-8852.vol-41-no-2.13119","volume":"41","author":"W Ben Kridis","year":"2019","unstructured":"Ben Kridis W, Werda I, Charfi S, Toumi N, Boudawara T, Mzali R, Daoud J, Khanfir A (2019) Buschke - Lowenstein anal tumor: an ambiguous entity. Exp Oncol 41(2):182\u2013184. https:\/\/doi.org\/10.32471\/exp-oncology.2312-8852.vol-41-no-2.13119","journal-title":"Exp Oncol"},{"issue":"9","key":"3569_CR10","doi-asserted-by":"publisher","first-page":"e3244","DOI":"10.7759\/cureus.3244","volume":"10","author":"DC Morse","year":"2018","unstructured":"Morse DC, Tschen JA, Silapunt S (2018) A rare variant of penile squamous cell carcinoma in a man with paraplegia. Cureus 10(9):e3244. https:\/\/doi.org\/10.7759\/cureus.3244","journal-title":"Cureus"},{"issue":"6","key":"3569_CR11","doi-asserted-by":"publisher","first-page":"938","DOI":"10.1111\/his.13158","volume":"70","author":"N Zidar","year":"2017","unstructured":"Zidar N, Langner C, Odar K, Hosnjak L, Kamaradova K, Daum O, Pollheimer MJ, Kosorok P, Poljak M (2017) Anal verrucous carcinoma is not related to infection with human papillomaviruses and should be distinguished from giant condyloma (Buschke-Lowenstein tumour). Histopathology 70(6):938\u2013945. https:\/\/doi.org\/10.1111\/his.13158","journal-title":"Histopathology"},{"issue":"2","key":"3569_CR12","doi-asserted-by":"publisher","first-page":"172","DOI":"10.4251\/wjgo.v11.i2.172","volume":"11","author":"S Shenoy","year":"2019","unstructured":"Shenoy S, Nittala M, Assaf Y (2019) Anal carcinoma in giant anal condyloma, multidisciplinary approach necessary for optimal outcome: two case reports and review of literature. World J Gastrointest Oncol 11(2):172\u2013180. https:\/\/doi.org\/10.4251\/wjgo.v11.i2.172","journal-title":"World J Gastrointest Oncol"},{"issue":"1","key":"3569_CR13","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1002\/1097-0142(196601)19:1<26::aid-cncr2820190103>3.0.co;2-l","volume":"19","author":"FT Kraus","year":"1966","unstructured":"Kraus FT, Perezmesa C (1966) Verrucous carcinoma. Clinical and pathologic study of 105 cases involving oral cavity, larynx and genitalia. Cancer 19(1):26\u201338. https:\/\/doi.org\/10.1002\/1097-0142(196601)19:1<26::aid-cncr2820190103>3.0.co;2-l","journal-title":"Cancer"},{"key":"3569_CR14","doi-asserted-by":"publisher","first-page":"212","DOI":"10.3389\/fonc.2015.00212","volume":"5","author":"R Brodbeck","year":"2015","unstructured":"Brodbeck R, Horch RE, Arkudas A, Beier JP (2015) Plastic and reconstructive surgery in the treatment of oncological perineal and genital defects. Front Oncol 5:212. https:\/\/doi.org\/10.3389\/fonc.2015.00212","journal-title":"Front Oncol"},{"issue":"2","key":"3569_CR15","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1055\/s-0036-1580627","volume":"29","author":"C Peirce","year":"2016","unstructured":"Peirce C, Martin S (2016) Management of the perineal defect after abdominoperineal excision. Clin Colon Rectal Surg 29(2):160\u2013167. https:\/\/doi.org\/10.1055\/s-0036-1580627","journal-title":"Clin Colon Rectal Surg"},{"issue":"7","key":"3569_CR16","doi-asserted-by":"publisher","first-page":"813","DOI":"10.1007\/s00384-014-1868-0","volume":"29","author":"RE Horch","year":"2014","unstructured":"Horch RE, Hohenberger W, Eweida A, Kneser U, Weber K, Arkudas A, Merkel S, Gohl J, Beier JP (2014) A hundred patients with vertical rectus abdominis myocutaneous (VRAM) flap for pelvic reconstruction after total pelvic exenteration. Int J Color Dis 29(7):813\u2013823. https:\/\/doi.org\/10.1007\/s00384-014-1868-0","journal-title":"Int J Color Dis"},{"issue":"2","key":"3569_CR17","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1007\/s00384-015-2402-8","volume":"31","author":"AH Abdou","year":"2016","unstructured":"Abdou AH, Li L, Khatib-Chahidi K, Troja A, Looft P, Gudewer EM, Raab HR, Antolovic D (2016) Free latissimus dorsi myocutaneous flap for pelvic floor reconstruction following pelvic exenteration. Int J Color Dis 31(2):385\u2013391. https:\/\/doi.org\/10.1007\/s00384-015-2402-8","journal-title":"Int J Color Dis"},{"key":"3569_CR18","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1186\/1477-7819-12-319","volume":"12","author":"M Fujioka","year":"2014","unstructured":"Fujioka M, Hayashida K, Morooka S, Saijo H, Nonaka T (2014) Combined serratus anterior and latissimus dorsi myocutaneous flap for obliteration of an irradiated pelvic exenteration defect and simultaneous site for colostomy revision. World J Surg Oncol 12:319. https:\/\/doi.org\/10.1186\/1477-7819-12-319","journal-title":"World J Surg Oncol"},{"issue":"1","key":"3569_CR19","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1097\/01.sap.0000250743.78576.35","volume":"58","author":"TM Oswald","year":"2007","unstructured":"Oswald TM, Stover SA, Gerzenstein J, Lei MP, Zhang F, Muskett A, Hu E, Angel MF, Lineaweaver WC (2007) Immediate and delayed use of arteriovenous fistulae in microsurgical flap procedures: a clinical series and review of published cases. Ann Plast Surg 58(1):61\u201363. https:\/\/doi.org\/10.1097\/01.sap.0000250743.78576.35","journal-title":"Ann Plast Surg"},{"issue":"1","key":"3569_CR20","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1177\/1538574411418843","volume":"46","author":"B Lind","year":"2012","unstructured":"Lind B, McCarthy W, Derman G, Jacobs C (2012) Arteriovenous loop grafts for free tissue transfer. Vasc Endovasc Surg 46(1):30\u201333. https:\/\/doi.org\/10.1177\/1538574411418843","journal-title":"Vasc Endovasc Surg"},{"issue":"11","key":"3569_CR21","doi-asserted-by":"publisher","first-page":"e1913","DOI":"10.1097\/gox.0000000000001913","volume":"6","author":"MS Radwan","year":"2018","unstructured":"Radwan MS, Barakat AZ, Jaber MM, Mashal AA (2018) Free flap transfer with arteriovenous loop establishment for upper limb salvage in a crush injury. Plast Reconstr Surg Global Open 6(11):e1913. https:\/\/doi.org\/10.1097\/gox.0000000000001913","journal-title":"Plast Reconstr Surg Global Open"},{"issue":"2","key":"3569_CR22","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1590\/1413-785220182602187220","volume":"26","author":"GB Silva","year":"2018","unstructured":"Silva GB, Veronesi BA, Torres LR, Imaguchi RB, Cho AB, Nakamoto HA (2018) Role of arteriovenous vascular loops in microsurgical reconstruction of the extremities. Acta Ortop Bras 26(2):127\u2013130. https:\/\/doi.org\/10.1590\/1413-785220182602187220","journal-title":"Acta Ortop Bras"}],"updated-by":[{"DOI":"10.1007\/s00384-021-04042-1","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2021,10,30]],"date-time":"2021-10-30T00:00:00Z","timestamp":1635552000000}}],"container-title":["International Journal of Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00384-020-03569-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00384-020-03569-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00384-020-03569-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,30]],"date-time":"2021-10-30T02:22:33Z","timestamp":1635560553000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00384-020-03569-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,17]]},"references-count":22,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2020,7]]}},"alternative-id":["3569"],"URL":"https:\/\/doi.org\/10.1007\/s00384-020-03569-z","relation":{},"ISSN":["0179-1958","1432-1262"],"issn-type":[{"value":"0179-1958","type":"print"},{"value":"1432-1262","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3,17]]},"assertion":[{"value":"6 March 2020","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 March 2020","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 October 2021","order":3,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":4,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":5,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1007\/s00384-021-04042-1","URL":"https:\/\/doi.org\/10.1007\/s00384-021-04042-1","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Yes.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The authors affirm that the patient has consented to the submission of the case report for submission to a scientific journal. Moreover, the authors affirm that the patient provided informed consent for publication of the images in Figs.\n                      \n                      to\n                      \n                      .","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}