Zhao Y, Wijaya R
Department of General Surgery, Changi General Hospital, 2 Simei Street 3, S529889, Republic of Singapore.
Department of General Surgery, Changi General Hospital, 2 Simei Street 3, S529889, Republic of Singapore.
Int J Surg Case Rep. 2020;71:277-279. doi: 10.1016/j.ijscr.2020.05.020. Epub 2020 May 21.
Anal canal tumors are uncommon amongst gastrointestinal tumors or anorectal tumors. While the majority of them seem to be squamous cell carcinoma in nature, adenocarcinoma may be equally as common amongst the Asian population. Recurrent nodal metastasis from a primary anal malignancy is not a rare occurrence in view of the anatomy of the anal canal.
A 70 year-old patient underwent surgery for synchronous sigmoid and anal adenocarcinoma in 2015. He then re-presented 2 years later with recurrence in the right inguinal lymph nodes. He subsequently underwent a right ilio-inguinal lymph node block dissection with a Sartorius flap creation.
As most anal canal tumors are squamous cell carcinomas, the optimal treatment for recurrent ilioinguinal lymph node disease has been well-established. This usually involves groin dissection as surgical treatment, with consideration for adjuvant combined chemoradiotherapy. Such an approach is likely to be beneficial for ilioinguinal lymph node disease from primary anal canal adenocarcinomas as well.
Physicians caring for patients with primary anal adenocarcinoma should be vigilant for possible ilioinguinal lymph node metastasis as this is not a rare occurrence. Surgical treatment appears to be a reasonable approach, with consideration for adjuvant therapy.
肛管肿瘤在胃肠道肿瘤或肛肠肿瘤中并不常见。虽然它们大多数本质上似乎是鳞状细胞癌，但腺癌在亚洲人群中可能同样常见。鉴于肛管的解剖结构，原发性肛门恶性肿瘤的复发性淋巴结转移并不罕见。
一名70岁患者于2015年接受了同步乙状结肠和肛门腺癌手术。两年后，他因右侧腹股沟淋巴结复发再次就诊。随后，他接受了右髂腹股沟淋巴结整块清扫术并创建了缝匠肌皮瓣。
由于大多数肛管肿瘤是鳞状细胞癌，复发性髂腹股沟淋巴结疾病的最佳治疗方法已经确立。这通常包括腹股沟清扫术作为手术治疗，并考虑辅助联合放化疗。这种方法可能对原发性肛管腺癌引起的髂腹股沟淋巴结疾病也有益。
治疗原发性肛门腺癌患者的医生应警惕可能发生的髂腹股沟淋巴结转移，因为这种情况并不罕见。手术治疗似乎是一种合理的方法，并考虑辅助治疗。
