Anand Bhupinder S, Verstovsek Gordana, Cole George
Department of Medicine, Digestive Diseases Section (111D), Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, Houston, TX 77030, USA.
World J Gastroenterol. 2006 Mar 21;12(11):1780-1. doi: 10.3748/wjg.v12.i11.1780.
Tumors arising from the anal canal are usually of epithelial origin and are mostly squamous cell carcinoma or basal cell carcinoma. We present a case of benign anal adenomas arising from the anus, an extremely rare diagnosis. A 78-year-old white man presented with rectal bleeding of several months duration. Examination revealed a 4 cm friable mass attached to the anus by a stalk. At surgery, the mass was grasped with a Babcock forceps and was resected using electrocautery. Microscopic examination revealed a tubulovillus adenoma with no areas of high grade dysplasia or malignant transformation. The squamocolumnar junction was visible at the edges of the lesion confirming the anal origin of the tumor. We believe the tubulovillus adenoma arose from either an anal gland or its duct that opens into the anus. Although seen rarely, it is important to recognize and treat these tumors at an early stage because of their potential to transform into adenocarcinoma.
起源于肛管的肿瘤通常起源于上皮组织,大多为鳞状细胞癌或基底细胞癌。我们报告一例起源于肛门的良性肛门腺瘤病例,这是一种极为罕见的诊断。一名78岁白人男性出现持续数月的直肠出血。检查发现一个4厘米的易碎肿物,通过蒂附着于肛门。手术时,用巴布科克钳夹住肿物并用电灼切除。显微镜检查显示为管状绒毛状腺瘤,无高级别发育异常或恶变区域。在病变边缘可见鳞柱交界,证实肿瘤起源于肛门。我们认为管状绒毛状腺瘤起源于肛门腺或其通向肛门的导管。尽管很少见,但由于这些肿瘤有转化为腺癌的可能性,早期识别和治疗很重要。