Objective: Ano-rectal fistula rankes second of ano-rectal diseases. The pathology of the most of cases is acute inflammation, in few case is tuberculosis but mucinous adenocarcinoma is very rare. The authors report 3 cases mucinous adenocarcinoma in 3045 cases ano-rectal fistula underwent surgery in the University Medical Center in 6 years. Material and method: Clinical communication regarding 3 cases of mucinous adenocarcinoma which we had collected among 3045 cases anorectal fistula underwent surgery at the hospital. Results: The study found out 3 cases mucinous adenocarcinoma in 3045 cases ano-rectal fistula in the University Medical Center. One case developed local recurrence (six years follow-up), the other two cases had not developed local recurrence due to short time follow-up. All three cases had not undergone either abdominoperineal excision of the rectum or radiotherapy or chemotherapy. The cause of cancer still controversy, mucinous adenocarcinoma arising from chronic anofistula or anal abscess. It is very difficult to detect it because the symptom often appear very late and non-specific except from the pathology post-operation. Miles operation is the best treatment, radiotherapy and chemotherapy are adjuvant therapy but the result is still controversy. It is high rate mortality if the patient is not underwent Miles operation and had not adjuvant therapy with chemotherapy and radiotherapy. Conclusion: Although the rate is very low (0.09 percent- 3/3045) but it is the cause that must be paid attention. The fistula tract tissue must be sent to the pathology laboratory. Radical therapy with the Miles operation in the best treatment.
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