Department of Surgery, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara, Chiba, 299-0111, Japan.
World J Surg Oncol. 2018 Jul 21;16(1):148. doi: 10.1186/s12957-018-1451-1.
The clinical findings of early anal gland carcinoma (AGC) have not been well delineated because AGC is a rare malignancy usually diagnosed at an advanced stage. Knowledge of the characteristic findings will be helpful for both diagnosis and determination of the treatment options for early AGC.
A 62-year-old man was referred to our hospital for treatment of a rectal submucosal tumor (SMT) detected during a medical checkup at another hospital. Trans-sacral resection of the tumor was performed under the diagnosis of a rectal benign cyst. Pathological examination of the resected tumor showed a mucin-producing adenoma. About 14 months later, a new cystic lesion was found by follow-up examination, and trans-sacral resection of the tumor was performed again. The second pathological diagnosis was a mucinous adenocarcinoma with a possible remnant tumor at the local site. After providing sufficient informed consent, the patient underwent intersphincteric resection (ISR) of the rectum to preserve anal function. The final diagnosis was mucinous adenocarcinoma of the anal gland, T1N0M0. The patient remained alive without recurrence or complications for 6 years 7 months postoperatively.
We have herein reported a case of early AGC with a characteristic SMT-like appearance. Because the anal gland is located within both the submucosal layer and the internal sphincter muscle, ISR may be selected when the tumor is limited to inside the gland.
由于早期肛门腺癌 (AGC) 的临床发现尚未得到很好的描述，因为 AGC 是一种罕见的恶性肿瘤，通常在晚期诊断。了解其特征性表现将有助于早期 AGC 的诊断和治疗方案的确定。
一名 62 岁男性因在另一家医院体检时发现直肠黏膜下肿瘤 (SMT) 而被转至我院治疗。根据直肠良性囊肿的诊断，对肿瘤进行了经骶骨切除。切除肿瘤的病理检查显示为产黏液性腺瘤。大约 14 个月后，通过随访检查发现了一个新的囊性病变，再次进行了经骶骨肿瘤切除术。第二次病理诊断为局部可能有残留肿瘤的黏液性腺癌。在充分知情同意后，患者接受了保留肛门功能的肛门内括约肌间切除术 (ISR)。最终诊断为肛门腺黏液性腺癌，T1N0M0。术后 6 年 7 个月，患者无复发或并发症，存活至今。
我们在此报告了一例具有特征性 SMT 样表现的早期 AGC 病例。由于肛门腺位于黏膜下层和内括约肌肌层内，当肿瘤局限于腺内时，可选择 ISR。
