Anal canal adenocarcinoma with pagetoid spread and inguinal lymph node metastasis treated with preoperative chemoradiotherapy: A case report

Nishikawa, Takeshi; Ushiku, Tetsuo; Emoto, Shigenobu; Murono, Koji; Kaneko, Manabu; Sonoda, Hirofumi; Sasaki, Kazuhito; Shuno, Yasutaka; Tanaka, Toshiaki; Hata, Keisuke; Kawai, Kazushige; Nozawa, Hiroaki; Ishihara, Soichiro

doi:10.3892/mco.2020.2017

Cited by 2 publications

(2 citation statements)

References 14 publications

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“…Immunohistochemistry is also useful for differentiating these carcinomas. Rectal-type carcinoma showed CK7 negativity, CK19 positivity, and MUC5AC negativity, whereas the carcinoma derived from the anal gland showed CK7 positivity, CK19 positivity, and MUC5AC positivity [ 15 , 16 ]. The present case was positive for CK7 ( Figure 5(a) ), CK19 ( Figure 5(b) ), and MUC5AC ( Figure 5(f) ), which was similar to the pattern of anal gland type carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Rare Anal Canal Cancer with Secondary Extramammary Paget’s Disease (Pagetoid Spread) Complicated by Squamous Cell Carcinoma of the Skin

Kusuhara

Ito

Matsuoka

et al. 2021

Case Reports in Surgery

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A 91-year-old man had a node and erythema in the anal area resistant to treatment. A biopsy of the node in the anus showed atypical cells developing as Paget’s disease, and staining revealed that the cells were CK7-positive, CK20-positive, and GCDFP15-negative. Therefore, tumor invasion with pagetoid spread (PS) from the anus to the skin was suspected, and the patient was referred to our department for a close examination and surgical treatment. Lower gastrointestinal endoscopy showed edematous, hemorrhagic mucosa in the anal canal, and he was diagnosed with adenocarcinoma via a biopsy. Additionally, redness and swelling with white moss were observed on the skin around the anus. Biopsy showed that Paget cells were diffusely present in the epithelium, and an image of squamous cell carcinoma directly under the epithelium was obtained. Taken together, the patient was diagnosed with the invasion of anal canal cancer with PS to the skin, and we performed laparoscopic abdominoperineal resection and skin carcinoma resection in the perineum. The histopathological analysis showed adenocarcinoma invading the external anal sphincter and subcutaneous adipose tissue in the vicinity of the pectinate line of the anal canal. Pagetoid spread of the adenocarcinoma was observed in the epidermis, and the open portion was slightly invaded up to the rectal mucosa. The anal skin region of the adenocarcinoma partially continued to the hair follicles, and it was complicated by squamous cell carcinoma invading the dermis. There are a few reports of anal canal cancer with PS, and the coexistence of adenocarcinoma and squamous cell carcinoma, as seen in the present case, is rare. We report our case together with relevant literature.

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Section: Discussionmentioning

confidence: 99%