UI - 12068206
AU - Laureti S; Ugolini F; D'Errico A; Rago S; Poggioli G
Adenocarcinoma below ileoanal anastomosis for ulcerative colitis: report
of a case and review of the literature.
SO - Dis Colon Rectum 2002 Mar;45(3):418-21
AD - Unita di Chirurgia, Policlinico S. Orsola, Universita di Bologna, Italy.
BACKGROUND: Restorative proctocolectomy with hand-sewn ileoanal
anastomosis and mucosectomy is warranted in patients with dysplasia
and/or cancer on ulcerative colitis to prevent subsequent neoplastic
changes in the retained mucosa. However, complete excision of the
colonic mucosa cannot be obtained reliably. We report a case of anal
canal adenocarcinoma after handsewn anastomosis with mucosectomy.
METHODS: A 47-year-old patient, previously submitted to ileorectal
anastomosis for colonic cancer on ulcerative colitis, underwent
completion proctectomy and handsewn ileoanal anastomosis with
mucosectomy for recurrent anastomotic cancer. Two years later, we
submitted the patient to pouch removal with permanent ileostomy for a
mucinous adenocarcinoma of the anal canal (T2N2Mx) found at follow-up
pouch endoscopy. CONCLUSIONS: Only four cases of adenocarcinoma after
handsewn anastomosis have been reported in the literature. This new case
we report confirms that the risk of malignancy after ileoanal
anastomosis with mucosectomy, although small, is real, despite the
surgeon taking care with this particular step of the procedure. Careful
surveillance is needed in patients with surgical treatment for long-term
ulcerative colitis or dysplasia.
UI - 11982993
AU - Cortes LM; Salamanca SP; Lopez AR; Rayward J; Medina TP; del Barrio
Fernandez P; Arenas JM
Contribution of volumetric three-dimensional ultrasound to the prenatal
diagnosis of a soft anal tumor.
SO - Ultrasound Obstet Gynecol 2002 May;19(5):526-7
UI - 12004221
AU - Baratsis S; Hadjidimitriou F; Christodoulou M; Lariou K
Adenocarcinoma in the anal canal after ileal pouch-anal anastomosis for
ulcerative colitis using a double stapling technique: report of a case.
SO - Dis Colon Rectum 2002 May;45(5):687-91; discussion 691-2
AD - 1st Surgical Department and Transplant Unit, "Evangelismos" General
Hospital, Athens, Greece.
A case of adenocarcinoma, developed in the anal canal after ileal
pouch-anal anastomosis for ulcerative colitis using a double stapling
technique, is reported. In this case a T3N0 cecal cancer was found
unexpectedly in the colectomy specimen. Two years later, this patient
presented with an outlet obstruction of the pouch because of development
of an adenocarcinoma of the anal canal. This was treated with an
abdominoperineal excision of the pouch and anorectum.
UI - 11972565
AU - Erlich R; Hedlund SC; Kulakowski K; Knopp J
Management of squamous cell carcinoma of the anus.
SO - Cancer Pract 2002 May-Jun;10(3):118-21
AD - Medical Oncology, Johns Hopkins Bayview Medical Center, Balitmore, MD,
UI - 11701985
AU - Noel JC; Sornin de Leysat C; Peny MO; van de Stadt J; Fayt I; De
Warty carcinoma of the anus: a variant of squamous cell carcinoma
associated with anal intraepithelial neoplasia and human papillomavirus
SO - Dermatology 2001;203(3):262-4
AD - Department of Pathology, Erasme University Hospital, Free University of
Brussels, Belgium. firstname.lastname@example.org
Warty carcinoma (WC) is a rare variant of squamous cell carcinoma
primarily described in the vulva in younger women and classically
associated with human papillomavirus (HPV) infection. The gross findings
are similar to those of verrucous carcinoma with large, exophytic tumors
with a papillomatous surface. Microscopically, the tumor is papillated
and contains fibrovascular cores covered by hyperkeratotic epithelium
showing presence of koilocytes. We report a case of anal squamous cell
carcinoma showing similar features, occurring in a young
immunosuppressed male patient with a history of multifocal anal
intraepithelial neoplasia (AIN). HPV-16 has been demonstrated both in
the WC and in adjacent AIN, but the HPV status appears different in the
two lesions: integrated in WC and episomal in AIN lesions. We also have
demonstrated by immunohistochemistry that both WC and AIN are highly
proliferative entities sharing the same MIB-1 pattern, and that
WAF1/CIP1 protein expression is common in the two lesions irrespective
of p53 protein expression. Copyright 2001 S. Karger AG, Basel
UI - 12065790
AU - Esiashvili N; Landry J; Matthews RH
Carcinoma of the anus: strategies in management.
SO - Oncologist 2002;7(3):188-99
AD - Emory University School of Medicine, Department of Radiation Oncology,
Atlanta, Georgia, USA.
The management of anal cancer underwent an interesting transformation
over the last two decades. Prior to this period, the standard definitive
treatment for carcinoma of the anal canal was abdominal-perineal
resection, which necessitated a permanent colostomy. The organ
preservation concept appeared following the discovery of a high complete
response rate from preoperative combined chemoradiation prior to
abdominal-perineal resection. The organ preservation method of treatment
rapidly gained popularity and ultimately saved a large number of
patients from undergoing abdominal-perineal resection and colostomy.
Chemoradiation treatment itself subsequently went through an
evolutionary process. Several studies have sought to define the optimal
chemotherapeutic regimen as well as radiation treatment dose and
fractionation. Ongoing studies attempt to define an optimal treatment
regimen that yields a higher cure rate while minimizing toxicity. We
review the etiology, epidemiology, and treatment regimens for anal
UI - 12118566
AU - John M; Flam M; Palma N
Ten-year results of chemoradiation for anal cancer: focus on late
SO - Int J Radiat Oncol Biol Phys 1996 Jan 1;34(1):65-9
AD - Central California Cancer Research Group, Fresno, USA.
PURPOSE: To evaluate (a) long-term survival and (b) the incidence and
nature of long-term morbidity/ mortality related to chemoradiation using
patients), and II (14 patients) cancers of the anal canal were treated
definitively with a chemoradiation regimen combining 41.4 Gy pelvic
radiotherapy with two concurrent cycles of 5-fluorouracil and mitomycin
C. Cumulative actuarial survival was calculated at 10 years and
long-term morbidity was categorized per RTOG/EORTC late toxicity
criteria. Specific criteria to grade anal toxicity were devised.
RESULTS: Cumulative survival for all 34 patients was 92% at 5 years and
85% at 10 years. The most frequent late toxicity was chronic diarrhea in
17 (50%) patients. Five patients (15%) had Grade 3 or 4 late toxicities.
Sexual dysfunction was present in 2 of 26 evaluable patients (7%).
CONCLUSIONS: Excellent long-term survival and colostomy-free survival is
possible for anal cancer patients treated definitively by
chemoradiation. Late effects do not appear to be frequent or intense
enough to deter the use of chemoradiation in anal cancer. The
biologically expected increase in long-term toxicity when combining
radiotherapy and chemotherapy is not substantiated by the results of
UI - 12088459
AU - Sawh RN; Borkowski J; Broaddus R
Metastatic renal cell carcinoma presenting as a hemorrhoid.
SO - Arch Pathol Lab Med 2002 Jul;126(7):856-8
AD - Department of Pathology, University of Texas M.D. Anderson Cancer
Center, Houston, TX 77030, USA.
Metastatic, noncolorectal carcinoma involving the anal canal is
exceptionally rare, with only 3 cases being described in the medical
literature. We report the case of a 53-year-old man with an anal mass
clinically presenting as a large, thrombosed, internal hemorrhoid. The
patient had a history of nephrectomy for renal cell carcinoma 9 years
previously. The resected anal lesion was histologically identical to the
primary tumor in the kidney, showing features of renal cell carcinoma of
the clear cell type. To the best of our knowledge, this is only the
fourth reported case of metastatic, noncolorectal carcinoma involving
the anal canal and is the first report of a renal cell carcinoma
metastasis to this site.
UI - 11765351
AU - Belnome N; Salibra M; Bartolo V; Turrisi M; Cesario E; Di Mauro S
SO - Ann Ital Chir 2001 May-Jun;72(3):329-34; discussion 334-5
AD - Cattedra di Chirurgia Generale, Universita degli Studi di Messina.
The authors, want to demonstrate the operation of abdominal perianal
rectum amputation, and it is considered absolute, even 80 years, in the
treatment of the anal neoplasia, it is superseded by alternative methods
represented by protocols radio-chemo-therapeutic associated or less to
the surgery treatment. They make then a retrospective valuation since
1963 till our days on 54 patients. In the 6 patients (stadium I-II)
treated after 1982 with protocols of freemall, it is was obtained
disappearance of the neoplasia about 50% the cases. On overcoming of the
results there was in a second group of 8 patients (1987) treated always
with protocol of Greenall, in 5 of these (62.5%) could observe absence
of remaining of disease. In the third group (1993) on 8 patients treated
with therapy fixed radio-chemo, it was registered the absence of the
residual of illness in 6 patients(75.5%). Finally, from the analysis of
patients observed in the last seven years, 5 of which suffered by Ca
squamous in different evolutive stadium (one I stadium, three II stadium
and one stadium III-B), the stadium I and II were treated with the
protocol radio-chemotherapeutic obtaining total remission of the disease
in the 100% of the cases. In the follow-up of 45 patients, 12 of whose
were treated with the therapy combined radio-chemo and of these 10 were
valuable for survival to 5 years which was about 70% superior to
patients treated with only surgery therapy.
UI - 12085257
AU - Bjorge T; Engeland A; Luostarinen T; Mork J; Gislefoss RE; Jellum E;
Koskela P; Lehtinen M; Pukkala E; Thoresen SO; Dillner J
Human papillomavirus infection as a risk factor for anal and perianal
skin cancer in a prospective study.
SO - Br J Cancer 2002 Jul 1;87(1):61-4
AD - Department of Pathology, The Norwegian Radium Hospital, 0310 Oslo,
Human papillomavirus has emerged as the leading infectious cause of
cervical and other anogenital cancers. We have studied the relation
between human papillomavirus infection and the subsequent risk of anal
and perianal skin cancer. A case-cohort study within two large Nordic
serum banks to which about 760 000 individuals had donated serum samples
was performed. Subjects who developed anal and perianal skin cancer
during follow up (median time of 10 years) were identified by registry
linkage with the nationwide cancer registries in Finland and Norway.
Twenty-eight cases and 1500 controls were analysed for the presence of
IgG antibodies to HPV 16, 18, 33 or 73, and odds ratios of developing
anal and perianal skin cancer were calculated. There was an increased
risk of developing anal and perianal skin cancer among subjects
seropositive for HPV 16 (OR=3.0; 95%CI=1.1-8.2) and HPV 18 (OR=4.4;
95%CI=1.1-17). The highest risks were seen for HPV 16 seropositive
patients above the age of 45 years at serum sampling and for patients
with a lag time of less than 10 years. This study provides prospective
epidemiological evidence of an association between infection with HPV 16
and 18 and anal and perianal skin cancer. Copyright 2002 Cancer Research
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