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肛周鳞状细胞癌:一例报告。

Perianal squamous cell carcinoma: A case report.

作者信息

Eliachevsky Christina, Templeton Erin, Nanda Atul K

机构信息

Medical Student, St. George's University School of Medicine, Grenada.

Chairman of Surgery, Humboldt Park Health, Chicago, IL, 60622, USA; Associate Professor of Surgery, St. George's University School of Medicine, Grenada.

出版信息

Int J Surg Case Rep. 2021 Apr;81:105739. doi: 10.1016/j.ijscr.2021.105739. Epub 2021 Mar 11.

Abstract

INTRODUCTION AND IMPORTANCE

Perianal carcinomas, though rare, are usually squamous cell carcinoma. Current literature recommends surgical excision for tumors staged T1-T2, N0 without external anal sphincter involvement, however our case demonstrated that tumors with superficial involvement of external sphincter fibers can be resected completely.

CASE PRESENTATION

A 45-year-old Caucasian male presented with a perianal mass found to be squamous cell carcinoma. Initial imaging suggested the anal sphincter was spared, however intraoperatively tumor cells were found involving superficial external sphincter fibers and a portion was excised to ensure complete removal.

CLINICAL DISCUSSION

Perianal squamous malignancies are often misdiagnosed as more benign conditions. Treatment aims to preserve sphincter function and depends on tumor stage along with anatomical involvement.

CONCLUSION

Despite superficial muscle infiltration, the T2N0 perianal lesion was curable with surgical resection alone without recurrence or functional deficits reported one year later. This suggests surgical management may be possible in some cases with sphincter involvement.

摘要

引言与重要性

肛周癌虽罕见,但通常为鳞状细胞癌。当前文献推荐对分期为T1 - T2、N0且未累及肛门外括约肌的肿瘤进行手术切除,然而我们的病例显示,累及外括约肌纤维浅层的肿瘤也可完全切除。

病例介绍

一名45岁的白种男性因肛周肿物就诊,经诊断为鳞状细胞癌。初始影像学检查提示肛门括约肌未受累,然而术中发现肿瘤细胞累及外括约肌纤维浅层,遂切除部分组织以确保完全切除。

临床讨论

肛周鳞状恶性肿瘤常被误诊为更良性的疾病。治疗旨在保留括约肌功能,其取决于肿瘤分期及解剖学受累情况。

结论

尽管存在肌肉浅层浸润,但该T2N0期肛周病变仅通过手术切除即可治愈,术后一年无复发或功能缺陷报告。这表明在某些括约肌受累的病例中,手术治疗可能是可行的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b812/8010385/908fbdb0e275/pl1.jpg

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