Sawai Katsuji, Goi Takanori, Tagai Noriyuki, Kurebayashi Hidetaka, Morikawa Mitsuhiro, Koneri Kenji, Tamaki Masato, Murakami Makoto, Hirono Yasuo, Maeda Hiroyuki
First Department of Surgery, University of Fukui, 23-3 Matsuoka Shimoaizuki Eiheiji-cho, Yoshidagun, Fukui, 910-1193, Japan.
Cancer Care Promotion Center, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka Shimoaizuki Eiheiji-cho, Yoshidagun, Fukui, 910-1193, Japan.
Surg Case Rep. 2022 Jun 20;8(1):119. doi: 10.1186/s40792-022-01474-x.
Currently, no established standard treatment exists for metastatic anal squamous cell carcinoma. We report a case of complete response in a patient with stage IV anal squamous cell carcinoma after undergoing multidisciplinary treatment.
A 62-year-old woman visited a nearby doctor with a chief concern of severe pain associated with a firm mass in the anus. The patient was diagnosed with anal canal squamous cell carcinoma and liver metastases and referred to First Department of Surgery Faculty of Medicine University of Fukui for treatment. The patient received a TNM classification of T4N0M1 and stage IV. Rectal amputation was performed; however, postoperative complications hindered immediate anticancer therapy and the liver metastases exacerbated. Radiofrequency hyperthermia and systemic chemotherapy were performed 3 months postoperatively. A prominent reduction in the liver metastasis was observed. Lung metastases appeared during the course of systemic chemotherapy. Radiotherapy was performed to treat the lung lesion and resolved. Radiotherapy was also performed for liver metastasis. The lesion in the liver showed resolution after 54 months postoperatively, and treatment with the anticancer drug was discontinued. Ten-year follow-up findings suggested complete resolution of the lesion in response to the treatment protocol followed in this case. This long-term survival was achieved through a multidisciplinary treatment.
The present case suggests that multidisciplinary treatment approach is effective for resolving stage IV anal squamous cell carcinoma, and addition of new anticancer drug therapy may improve the overall prognosis of squamous cell carcinoma.
目前，转移性肛管鳞状细胞癌尚无既定的标准治疗方法。我们报告一例IV期肛管鳞状细胞癌患者在接受多学科治疗后完全缓解的病例。
一名62岁女性因肛门处有硬块并伴有剧痛前往附近医生处就诊。该患者被诊断为肛管鳞状细胞癌伴肝转移，并被转诊至福井大学医学部第一外科进行治疗。患者的TNM分期为T4N0M1，处于IV期。进行了直肠切除术；然而，术后并发症阻碍了立即进行抗癌治疗，且肝转移恶化。术后3个月进行了射频热疗和全身化疗。观察到肝转移明显缩小。在全身化疗过程中出现了肺转移。对肺部病变进行了放疗并得到缓解。也对肝转移进行了放疗。术后54个月肝脏病变显示消退，抗癌药物治疗停止。十年随访结果表明，按照本病例采用的治疗方案，病变完全消退。这种长期生存是通过多学科治疗实现的。
本病例表明，多学科治疗方法对解决IV期肛管鳞状细胞癌有效，添加新的抗癌药物治疗可能改善鳞状细胞癌的总体预后。
