A Case Report of Anal Canal Cancer with Perianal Pagetoid Spread

Shota Kodama, Takashi Hirai, Tomoyuki Kato, Kouji Makibuchi, Yasunobu Fujimitsu, Takeshi Kito

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital

A 47-year-old male consulted a nearby physician, with anal bleeding and prolapse of an anal tumors as chief complaints, and underwent transanal local excision of the tumor. Histopathological examination of the resected specimen revealed well-differentiated adenocarcinoma invading as far as the muscularis propria and accompanied with perianal pagetoid spread, the extent of which had to be evaluated by skin biopsies. The patient is well and disease-free 7 months after undergoing abdomino-perineal resection with adequate incision of the perianal involved area. Cancer of the anal canal is seldom accompanied by pagetoid spread and only nine such cases, including ours, have been reported. The extent of perianal spread of the disease was not properly evaluated in any of the cases reported so far, and adequate management of the rare disease is described in the present case report with references to the literature.

Key words
anal canal cancer, skin biopsy, perianal pagetoid spread

Reprint requests
Shota Kodama Department of Gastroenterological Surgery, Aichi Cancer Center Hospital
1-1 Kanokoden, Chikusaku, Nagoya, 464 JAPAN

Accepted
February 14, 1996

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