Wang Bo, Jaiswal Sunny, Saif Muhammad W
Internal Medicine, Tufts Medical Center.
Department of Radiology, Tufts Medical Center.
Cureus. 2017 May 30;9(5):e1291. doi: 10.7759/cureus.1291.
Anal squamous cell carcinoma was a previously uncommon malignancy that has steadily increased in incidence with the increased prevalence of human papillomavirus (HPV) and human immunodeficiency virus (HIV). Anal squamous cell carcinoma is typically characterized by local and regional involvement and distant metastases are far less common. Here, we report a case of a 36-year-old female initially diagnosed with anal squamous cell carcinoma manifesting as an anal mass along with an enlarged inguinal lymph node. After receiving chemoradiation therapy, she remained disease-free until recently, when she presented with an isolated left infraclavicular lymph node found on physical examination followed by a biopsy that was consistent with recurrent anal squamous cell carcinoma. The positron emission tomography-computed tomography (PET-CT) uptake of her original left inguinal lymph node was decreased, suggesting improved regional disease, and no other metastases were found. Our case represents a rare occurrence of metastatic anal squamous cell carcinoma to an isolated distal lymph node and reminds physicians not to forget a unusual site of metastasis and prevent any delay in treatment.
肛管鳞状细胞癌是一种以前不常见的恶性肿瘤，随着人乳头瘤病毒（HPV）和人类免疫缺陷病毒（HIV）患病率的增加，其发病率稳步上升。肛管鳞状细胞癌的典型特征是局部和区域受累，远处转移则较为少见。在此，我们报告一例36岁女性，最初诊断为肛管鳞状细胞癌，表现为肛门肿物及腹股沟淋巴结肿大。接受放化疗后，她一直无病生存，直到最近体检发现孤立的左锁骨下淋巴结，活检结果与复发性肛管鳞状细胞癌一致。她原来左侧腹股沟淋巴结的正电子发射断层扫描-计算机断层扫描（PET-CT）摄取减少，提示局部疾病有所改善，未发现其他转移灶。我们的病例代表了罕见的肛管鳞状细胞癌转移至孤立的远端淋巴结的情况，提醒医生不要忽视不寻常的转移部位，避免治疗延误。
