管外型発育を呈した肛門管原発未分化癌の1例

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  • A CASE OF EXTRAMUCOSAL UNDIFFERENTIATED CARCINOMA OF THE ANAL CANAL

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Undiferentiated carcinoma of the anal canal is rare. We report a case of extramucosal carcinoma of the anal canal in which pre-and post-operative diagnosis was difficult.<br> An 81-year-old male was admitted with a complaint of constipation. Digital examination of the anal canal and rectum reveaeld annular stricture 5cm above the anal verge caused by an immobile hard mass. Colonoscopy showed annular stenosis between 3 and 6cm above the anal verge but no mucosal abnormalities. Endoscopic mucosal resection and peranal needle biopsy did not allows pathological diagnosis. After obtaining the patient's informed consent, abdominoperianal rectal excision was performed on suspicion of extramucosal anal cancer or malignant submucosal tumor. Microscopic examination of the resected specimen showed that undifferentiated tumor cells had spread in an annular extraluminal fashion around the anal canal and the lower rectum and infiltrated the external sphincter muscle in the anal canal. The tumor cells were demonstrated to express cytokeratin and epithelial membrane antigen by immunohistochemical staining. Based on these findings, a diagnosis of extramucosal undifferentiated carcinoma of the anal canal was made.

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