Neoplasms of Anal Canal and Perianal Skin

Abstract

Tumors of the anus and perianal skin are rare. Their presentation can vary and often mimics common benign anal pathology, thereby delaying diagnosis and appropriate and timely treatment. The anatomy of this region is complex because it represents the progressive transition from the digestive system to the skin with many different co-existing types of cells and tissues. Squamous cell carcinoma of the anal canal is the most frequent tumor found in the anal and perianal region. Less-frequent lesions include Bowen's and Paget's disease, basal cell carcinoma, melanoma, and adenocarcinoma. This article aims to review the clinical presentation, diagnostic evaluation, and treatment options for neoplasms of the anal canal and perianal skin.

The clinicopathologic spectrum of anal cancer in KwaZulu-Natal Province, South Africa

“…Squamous carcinoma was almost six times as common as adenocarcinoma, occurring in 85% which falls within the reported 75-85% [1,26,36,37]. Adenocarcinoma on the other hand occurred in 14% which also falls within the reported 3-19% [4,5,20,26,[36][37][38][39][40].…”

“…Twenty two patients (9%) presented with metastatic disease, the target organs being lungs (10), liver (10), peritoneum (2), bone (1) and pleura (1). Histopathological evidence of HPV or condyloma acuminata was documented in only nine and six patients respectively.…”

Perianal Paget’s Disease with synchronous adenocarcinoma: An unusual diagnosis

“…[6] Although, as a group, only 15% of the EMPD harbor an underlying neoplasm, a higher percentage of neoplasia is associated with PPD (up to 60%). [2,7] Surgical methods of treatment are still the mainstay, although other non-surgical modalities have been described (radiotherapy, chemo-radiotherapy, photodynamic therapy, imiquimod 5% cream). [8,9] Local recurrence is high (31%-61%), so long-term follow-up must be guaranteed.…”

Perianal melanoma with a BRAF gene mutation in a young Portuguese Roma native

“…AMMs typically present with symptoms of bleeding, pain and palpable mass, 30% of which are amelanotic 2. Hence, they can be initially mistaken for haemorrhoids, fissures or abscess 3…”