Undifferentiated Carcinoma of the Anal Canal with Metastatic Squamous Cell Carcinoma of the Inguinal Lymph Node

Mitsuhiro Inagaki, Hiroki Yamazaki, Takumi Saito, Naoyuki Chisato, Yoshiaki Ebisawa, Mitsuhiro Obara, Toru Kono, Yoshihiko Tokusashi*, Naoyuki Miyokawa* and Shinichi Kasai

Department of Surgery II and Department of Surgical Pathology*, Asahikawa Medical College

A 78-year-old man consulted us for anal bleeding and pain. Digital examination of the anus and rectum revealed internal and external hemorrhoids at 3 o'clock and 7 o'clocks, respectively. The patient was treated medically by drug therapy, but complained of continuous anal pains and the left inguinal lymph node rapidly enlarged. Surgical biopsy of the anal tumor and lymph node was performed under spinal anesthesia. Pathological examination revealed poorly differentiated carcinoma of the anal canal and the lymph node metastasis. Abdominoperineal rectal excision was performed and followed by 4 cycles of chemotherapy with irinotecan, leucovorin, fluorouracil, and doxyfluridine. The patient died six months later of carcinomatosis. Undifferentiated carcinoma of the anal canal is rare. We have reported a case of undifferentiated carcinoma of the anal canal and metastatic squamous cell carcinoma to inguinal nodes in which the outcome was poor after resection.

Key words
carcinoma of the anal canal, undifferentiated carcinoma, abdominoperineal rectal excision

Reprint requests
Mitsuhiro Inagaki Department of Surgery II, Asahikawa Medical College
2-1-1-1 Midorigaoka-Higashi, Asahikawa, 078-8510 JAPAN

Accepted
June 22, 2005

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