Ji Yong, Zhou Youxin
Department of General Surgery, People Hospital of Jingjiang, YangZhou University Medical Academy, Jingjiang, Taizhou, China.
Medicine (Baltimore). 2019 Jan;98(1):e13877. doi: 10.1097/MD.0000000000013877.
Adenocarcinoma of the anal canal is an uncommon malignancy. Primary adenocarcinoma, in particular, is extremely rare.
A 61-year-old man was referred to our institution with complaints of repeated hematochezia.
Digital rectal examination revealed a hard palpable ulcer in the anal canal, measuring 2 cm × 2 cm in size, at the 5 o'clock direction (in the lithotomy position). The pelvic enhanced magnetic resonance imaging revealed anal verge occupying mass. A diagnosis of carcinoma of the anal canal was considered. Colonoscopic examination revealed a poorly differentiated adenocarcinoma of the anal canal.
The patient underwent abdominoperineal resection (APR) of the rectum, and was administered 6 courses of adjuvant chemotherapy with mFOLFOX.
The patient was followed up for more than 1 year after operation, and no local recurrence or distant metastasis occurred.
The diagnosis and treatment of this disease is still a huge challenge because its incidence is very low. A study of more cases is required for uniformity in diagnosis and for the development of treatment protocols.
肛管腺癌是一种罕见的恶性肿瘤。尤其是原发性腺癌极为罕见。
一名61岁男性因反复便血被转诊至我院。
直肠指检发现肛管处有一个可触及的硬结溃疡,大小为2厘米×2厘米,位于截石位5点钟方向。盆腔增强磁共振成像显示肛门边缘占位性肿块。考虑诊断为肛管癌。结肠镜检查显示为低分化肛管腺癌。
患者接受了直肠腹会阴联合切除术(APR),并接受了6个疗程的mFOLFOX辅助化疗。
患者术后随访1年以上,未发生局部复发或远处转移。
由于该病发病率极低,其诊断和治疗仍然是一个巨大的挑战。需要更多病例研究以实现诊断的一致性并制定治疗方案。