• Pagetoid spread
• anorectal cancer
• robotic surgery

• Humans
• Female
• Hemorrhoids/drug therapy
• Hemorrhoids/complications
• Ointments
• Aged
• Middle Aged
• Anus Diseases/drug therapy
• Skin Ulcer/drug therapy
• Skin Ulcer/etiology
• Skin Ulcer/pathology
• Wound Healing/drug effects

• anal adenocarcinoma
• anal cancer
• total neoadjuvant therapy
• watch and wait

• Humans
• Retrospective Studies
• Neoadjuvant Therapy
• Watchful Waiting
• Rectal Neoplasms/pathology
• Anus Neoplasms/therapy
• Anus Neoplasms/pathology
• Chemoradiotherapy
• Adenocarcinoma/pathology
• Neoplasm Recurrence, Local/therapy
• Neoplasm Recurrence, Local/drug therapy
• Treatment Outcome
• Neoplasm Staging

• R01 CA182551 NCI NIH HHS
• R01 CA090559 NCI NIH HHS
• P30 CA008748 NCI NIH HHS
• L30 CA220812 NCI NIH HHS
• L30 CA209253 NCI NIH HHS
• K08 CA255574 NCI NIH HHS
• R37 CA248289 NCI NIH HHS

• Anal adenocarcinoma
• Prognosis
• Staging
• Surveillance, Epidemiology, and End Results
• Treatment patterns

• Adult
• Humans
• Female
• United States/epidemiology
• Aged
• Male
• Neoplasm Staging
• Anus Neoplasms/therapy
• Adenocarcinoma/pathology
• Rectal Neoplasms/pathology
• Carcinoma, Squamous Cell
• Retrospective Studies

• Perianal
• basal cell carcinoma (BCC)
• basosquamous
• case report

• IMRT
• case report
• perianal cancer
• perineal body
• radiotherapy

• Bowen's disease
• erythroplasia of Queyrat
• squamous cell carcinoma

• anal canal cancer
• cancer specific survival
• nomogram
• overall survival
• prognosis

• Human papillomavirus
• anal cancer

• Chemoradiotherapy
• Crohn’s disease
• Fistula-unrelated perianal squamous cell carcinoma

Described is a case of diffuse large B cell lymphoma that presented within a typical fistula tract, possibly secondary to oxidative stress within the fistula tract itself and consequent malignant change rather than a fistula as a consequence of necrosis in a lymphoma. If so it would be unique in the world literature. A 42-year-old fitness instructor presented with a typical appearing left lateral anal fistula. Biopsy of the fistulous tract revealed B cell lymphoma, graded 1E. Although chemotherapy cured the lymphoma, surgical treatment by ligation of the inter-sphincteric fistula tract was required to heal the fistula. At 3-year follow-up, there has been no recurrence of the lymphoma or the fistula. Neoplasia arising secondary to oxidative stress within an anal fistula is a well-established phenomenon. Early diagnosis of rare conditions associated with anal fistula can only be accomplished by routine biopsy of every fistula tract.

• NMSC
• SCC
• genomic profiling
• perianal SCC
• special location

•

Perianal squamous malignancies are often misdiagnosed leading to delay in treatment.

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.

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.

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.

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.

• Anal margin
• Case report
• General surgery
• Oncology
• Squamous cell carcinoma

• Anal canal
• Large bowel
• Magnetic resonance imaging

• anal carcinoma
• case report
• general dermatology
• medical dermatology
• metastasis
• oncology

• HPV vaccine
• cisgender women
• men who have sex with men
• men who have sex with women
• people living with HIV
• transgender women
• uptake

• Lymph node ratio
• Rectal cancer
• Survival

• Adult
• Aged
• Aged, 80 and over
• Carcinoma/mortality
• Carcinoma/pathology
• Disease-Free Survival
• Female
• Humans
• Lymph Node Excision
• Lymph Node Ratio
• Lymphatic Metastasis/pathology
• Male
• Middle Aged
• Prognosis
• Rectal Neoplasms/mortality
• Rectal Neoplasms/pathology
• Retrospective Studies
• Young Adult

• Adenocarcinoma
• Anal cancer
• Outcomes

Differentiated-type Intraepithelial Neoplasia (DIN) is defined as HPV-negative squamous intraepithelial proliferation with abnormal keratinocyte differentiation and basal cell atypia, originally described in the vulva, with following descriptions in the oral cavity. DIN occurring in the anus is quite rare, and to the best of our knowledge, only one publication reported it. In this report, we describe the clinicopathological features of this entity on anal margin, associated with invasive squamous cell carcinoma. In addition, using the next generation sequencing (NGS) technique, we have demonstrated TP53 mutation in the invasive component but not in the associated DIN-like lesion, where p53 immunohistochemical expression was restricted to basal layers.

Anal gland carcinoma with perianal Paget’s disease is rare, and anal gland carcinoma in situ is extremely rare. No cases of anal gland carcinoma in situ with pagetoid spread have been previously reported.

Physical examination in a 75-year-old woman revealed an erythematous, inflamed, perianal skin lesion. Neither colposcopy, cystoscopy, colonoscopy, computed tomography, nor magnetic resonance imaging showed evidence of malignant genitourinary or gastrointestinal lesions. Histopathological examination of a biopsy specimen showed many Paget’s cells in the perianal skin lesion and no malignant cells in the rectal or vaginal mucosa. Therefore, primary extramammary Paget’s disease of the anogenital region was suspected, and we performed anus-preserving wide local excision. However, immunohistochemistry revealed a diagnosis of secondary extramammary Paget’s disease due to adenocarcinoma arising from the anal gland. We therefore proceeded with a radical operation. Histopathological examination showed no residual cancer cells. The final diagnosis was anal gland adenocarcinoma in situ with pagetoid spread in the perianal skin.

This is the first case report of anal gland adenocarcinoma in situ with pagetoid spread. We recommend immunohistochemical analysis of biopsy and locally resected specimens to obtain an accurate diagnosis and determine the appropriate treatment when there is no visible tumor.

• Adenocarcinoma in situ
• Anal gland adenocarcinoma
• Perianal Paget’s disease

• Raf kinase inhibitor protein
• adenocarcinoma
• anal cancer
• high-grade squamous intra-epithelial lesion
• squamous-cell carcinoma

Anal adenocarcinoma is very rare and usually occurs in the elderly. We present a case of a 12-year-old girl with an anal margin painful tumor infiltrating the lower rectum, with perineal and vulvar permeation nodules and bilateral fixed inguinal and iliac lymph nodes. Histology showed anal adenocarcinoma with mucosecreting component and independent cells. She had no extra pelvic metastasis on CT scan. She underwent a colostomy and palliative care. This exceptional case challenges us on the diversity of forms of anal cancers that require a multidisciplinary approach. The precarious social context and the age of onset make it difficult to manage this rare cancer.

Primary adenocarcinoma of the anal canal is a rare and aggressive gastrointestinal disease with unclear pathogenesis. Because of its rarity, no clear clinical practice guideline has been defined and a targeted therapeutic armamentarium has yet to be developed. The present article aimed at addressing this information gap by in-depth characterising the anal glandular neoplasms at the histologic, immunologic, genomic and epidemiologic levels.

In this multi-institutional study, we first examined the histological features displayed by each collected tumour (n = 74) and analysed their etiological relationship with human papillomavirus (HPV) infection. The intratumoural immune cell subsets (CD4, CD8, Foxp3), the expression of immune checkpoints (PD-1, PD-L1), the defect in mismatch repair proteins and the mutation analysis of multiple clinically relevant genes in the gastrointestinal cancer setting were also determined. Finally, the prognostic significance of each clinicopathological variable was assessed.

Phenotypic analysis revealed two region-specific subtypes of anal canal adenocarcinoma. The significant differences in the HPV status, density of tumour-infiltrating lymphocytes, expression of immune checkpoints and mutational profile of several targetable genes further supported the separation of these latter neoplasms into two distinct entities. Importantly, anal gland/transitional-type cancers, which poorly respond to standard treatments, displayed less mutations in downstream effectors of the EGFR signalling pathway (i.e., KRAS and NRAS) and demonstrated a significantly higher expression of the immune inhibitory ligand-receptor pair PD-1/PD-L1 compared to their counterparts arising from the colorectal mucosa.

Taken together, the findings reported in the present article reveal, for the first time, that glandular neoplasms of the anal canal arise by HPV-dependent or independent pathways. These etiological differences leads to both individual immune profiles and mutational landscapes that can be targeted for therapeutic benefits.

•

We describe basal cell carcinoma in the perianal area.

Basal cell carcinomas are rare in non-sun-exposed skin, and are even rarer in the perianal region. Alertness to the unusual occurrence of this tumor at perianal site, with understanding of its clinical course, can prevent delay in its diagnosis and morbid aggressiveness in the management of the disease.

A 93 year old female, referred to our hospital because of a three month bleeding ulcerative lesion, with a diameter approximately of 4.5 × 3.2 cm, located in the perianal region.

Tumors of the anus and perianal are infrequent neoplasms of the digestive tract. There are many diseases that can be confused with this diagnosis and it is commonly delayed because the tumor is rarely thought of in this particular cutaneous topography. Suspicion and early diagnosis, give the opportunity for a timely and appropriate treatment and also prevent tumor extension.

Treatment modalities include early wide local excision to clear margins, ensuring further local recurrence and distant metastasis. The use of local V-Y advancement fasciocutaneous flaps may be another valid option for the reconstruction of perianal skin defects, with less morbidity than other flaps described in the literature.

• Bilateral V-Y flap
• Perianal basal cell carcinoma

• Cancer rehabilitation
• Colorectal cancer
• Health-related quality of life
• Mental health
• Pain
• Patients
• Physical health
• Psychoeducational
• Psychosocial
• Randomized controlled study
• SF-36

• Bowen’s disease
• multiple
• perianal

• Anus Neoplasms/pathology
• Bowen's Disease/pathology
• Female
• Humans
• Middle Aged
• Neoplasm Recurrence, Local/pathology
• Skin Neoplasms/pathology

• LGBT
• cancer
• health behavior
• health disparities
• sexual minorities
• survivorship

• Bisexuality/statistics & numerical data
• Female
• Global Health
• Homosexuality/statistics & numerical data
• Homosexuality, Female/statistics & numerical data
• Humans
• Male
• Morbidity/trends
• Neoplasms/epidemiology
• Survival Rate/trends
• Transgender Persons/statistics & numerical data

• P30 CA076292 NCI NIH HHS
• R25 CA174664 NCI NIH HHS

Anal canal adenoma is an extremely rare disease that has the potential to transform into a malignant tumor. We herein presented a rare case of metachronous multiple adenomas of the anal canal. A 48-year-old woman underwent total colonoscopy following a positive fecal blood test. A 9-mm villous polyp arising from the posterior wall of the anal canal was removed by snare polypectomy. Histologically, the tumor was tubulovillous adenoma with high-grade dysplasia and the cut end was negative for tumor cells. Six years later, an elevated lesion, macroscopically five millimeters in size, was detected in the left wall of the anal canal in a follow-up colonoscopy. Local excision of the tumor was performed, and the lesion was pathologically confirmed to be tubular adenoma with high-grade dysplasia limited to the mucosa. The patient is currently alive without any evidence of recurrence for six months after surgery. Although she had a past history of cervical cancer, the multiple tumors arising in the anal canal were unlikely to be related to human papilloma virus infection. Our case report underscores the importance of careful observations throughout colonoscopy to detect precancerous lesions, particularly in anatomically narrow segments.

Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer. Exposure to ultraviolet light is an important risk factor for BCC development and the disorder therefore develops commonly on body areas that are more exposed to sunlight, such as the face and neck. It is uncommon in the closed area of the body and quite rare in the perianal and genital regions. Herein, we report a 34-year-old patient with perianal BCC who had no additional risk factors.

• Basal cell carcinoma
• Local resection
• Perianal

Anal cancers (AC) are relatively rare tumors. Their incidence is increasing, particularly among men who have sex with other men due to widespread infection by human papilloma virus. The majority of anal cancers are squamous cell carcinomas, and they are treated according to stage. In local and locally advanced AC, concomitant chemoradiation therapy based on mitomycin C and 5-Fluorouracil (5-FU) is the current best treatment, while metastatic AC, chemotherapy with 5-FU and cisplatin remains the gold standard. There are no indications for induction or maintenance therapies in locally advanced tumors. Many novel strategies, such as targeted therapies, vaccination, immunotherapy and photodynamic therapy are in clinical trials for the treatment of AC, with promising results in some indications.

• Anal cancer
• Optimum treatment
• Updates
• Guidelines
• Novel approaches

• Animals
• Antineoplastic Combined Chemotherapy Protocols/standards
• Antineoplastic Combined Chemotherapy Protocols/therapeutic use
• Anus Neoplasms/mortality
• Anus Neoplasms/pathology
• Anus Neoplasms/therapy
• Anus Neoplasms/virology
• Carcinoma, Squamous Cell/mortality
• Carcinoma, Squamous Cell/secondary
• Carcinoma, Squamous Cell/therapy
• Carcinoma, Squamous Cell/virology
• Chemoradiotherapy/standards
• Cisplatin/administration & dosage
• Fluorouracil/administration & dosage
• Humans
• Mitomycin/administration & dosage
• Neoplasm Recurrence, Local
• Neoplasm Staging
• Neoplasm, Residual
• Papillomavirus Infections/complications
• Papillomavirus Infections/prevention & control
• Papillomavirus Infections/virology
• Papillomavirus Vaccines/therapeutic use
• Practice Guidelines as Topic
• Risk Factors
• Treatment Outcome

•

We present a case of metachronous anal canal adenocarcinoma.

Anal canal adenocarcinoma is an extremely rare malignancy with poorly defined diagnostic and treatment criteria.

A 42-year-old women was diagnosed with primary anal canal adenocarcinoma 11 months after undergoing anterior resection for primary sporadic rectal adeocarcinoma. Transanal excision was performed and additional adjuvant chemotherapy was given. Immunohistology showed positivity for cytokeratin (CK) 20 and CDX2, and negative CK7, which is compatible with colorectal subtype anal adenocarcinoma. At 6 months follow-up the patient has no evidence of recurrent or metastatic disease.

Diagnosis of primary anal adenocarcinoma is typically delayed because of its rarity, and vague clinical presentation. Exact histologic criteria remain poorly defined but the use of immunohistology has improved the overall diagnostic accuracy of anal adenocarcinoma and it also helps define its correct origin. Reports on the management and outcomes of this cancer consist mainly of retrospective studies with no consistent treatment strategy and limited comparison data. Most authors currently recommend neoadjuvant chemoradiotherapy and radical resection. Despite aggressive therapy, rates of local failure and distant recurrence remain high.

Diagnosis of adenocarcinoma of the anal canal is difficult but specific immunohistolgic patterns help to correctly identify its correct origin and subtype. Defining the correct subtype of anal adenocarcinoma may impact treatment strategies of this rare cancer.

• Adenocarcinoma
• Anal canal
• Case report
• Treatment

A non-healing peri-anal abscess can be difficult to manage and is often attributed to chronic disease. This case documents a male in his seventh decade who presented with multiple peri-anal collections. The abscess cavity had caused necrosis of the internal sphincter muscles resulting in faecal incontinence. Biopsies were conclusive for diffuse large B-cell lymphoma. A de-functioning colostomy was performed and the patient was initiated on CHOP-R chemotherapy. Anal lymphoma masquerading as a peri-anal abscess is rare. A high degree of suspicion must be maintained for an anal abscess which does not resolve with conservative management.

Perianal Paget's disease (PPD) represents a skin neoplasm which can be either primary or secondary to carcinoma from an adjacent internal organ. PPD with underlying colorectal adenocarcinoma is usually looked upon as a secondary disease. We report a rare case of co-associated PPD and anorectal adenocarcinoma. The PPD was found to be located near the anorectal adenocarcinoma with normal tissues between them. Immunohistochemical stains demonstrated that the Paget's cells were CK7+/GCDFP-15–/CK20–/MUC2–/CDX2–, whereas the anorectal adenocarcinoma was shown to be CK7+/GCDFP-15–/CK20+/MUC2+/CDX2+. This immunological phenotypic profile supported the notion that PPD and anorectal adenocarcinoma were of different origins, but could not define the exact origins of PPD. In our determination, this case was a primary PPD with anorectal adenocarcinoma. PPD remains a heterogeneous and complex pathology, and additional studies are required to differentiate between the various possible origins.

• Anorectal adenocarcinoma
• Cytokeratin 20
• Cytokeratin 7
• Gross cystic disease fluid protein 15
• Perianal Paget's disease

• Adenocarcinoma of an anal gland
• Cytokeratin 19
• Cytokeratin 7
• Immune-histochemical marker
• Pagetoid spread