Hajjar Roy, Richard Carole S, Aubin Francine, Campeau Marie-Pierre, Soucy Geneviève, Broux Éric De
Digestive Surgery Service, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada.
Hematology Oncology Service, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada.
J Clin Transl Res. 2021 Feb 2;7(1):121-126. eCollection 2021 Feb 25.
Primary small-cell carcinoma of the anal canal is an exceedingly rare tumor with a poor prognosis even when aggressive therapy is initiated. We present the case of a 53-year-old male patient who presented with chronic anal pain. Examination under general anesthesia revealed the presence of a mass in the anal canal. A biopsy was performed, and histopathological examination showed a high-grade neuroendocrine small-cell carcinoma. Assessment with endoscopic ultrasound showed an invasion of the internal anal sphincter. The patient was treated with a chemoradiotherapy (CRT) regimen consisting of cisplatin and etoposide, combined to radiotherapy. The patient achieved long-term remission with CRT. This is one of the first reports in the literature of a case of a high-grade neuroendocrine small-cell carcinoma of the anal canal where long-term remission was achieved with non-surgical management of a tumor invading the anal sphincter. This favorable evolution with CRT suggests that remission could still be achieved with anal small-cell carcinomas. More cases are however required to validate this approach.
This case presentation suggests that long-term remission can still be achieved using CRT and without an extensive surgical resection in patients with small-cell carcinoma of the anal canal.
肛管原发性小细胞癌是一种极为罕见的肿瘤，即便开始积极治疗，预后也很差。我们报告一例53岁男性患者，其表现为慢性肛门疼痛。全身麻醉下检查发现肛管有一肿物。进行了活检，组织病理学检查显示为高级别神经内分泌小细胞癌。内镜超声评估显示肛门内括约肌受侵。该患者接受了由顺铂和依托泊苷组成的同步放化疗方案，并联合放疗。患者通过同步放化疗实现了长期缓解。这是文献中首批报告之一，该病例为肛管高级别神经内分泌小细胞癌，肿瘤侵犯肛门括约肌，通过非手术治疗实现了长期缓解。同步放化疗的这种良好转归表明，肛管小细胞癌仍可实现缓解。然而，需要更多病例来验证这种方法。
该病例报告表明，肛管小细胞癌患者使用同步放化疗且无需广泛手术切除仍可实现长期缓解。
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