Abstract
A large variety of neoplasms are found in the anal canal and perianal region. Most are distinctly uncommon and may, therefore, pose the question of suitable therapy. For some neoplasms, the treatment of choice is clear cut, while for others it is controversial. Certainly for squamous cell carcinoma of the anal canal, there has been a major rethinking of the treatment of choice. This review highlights the types of lesions found in the anal region and the current status regarding their appropriate treatment.
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References
Morson BC, Pang LS. Pathology of anal cancer. Proc R Soc Med 1968;61:623–4.
Stearns MW, Jr, Quan SH. Epidermoid carcinoma of the anorectum. Surg Gynecol Obstet 1970;131:953–7.
Daling JR, Weiss NS, Hislop TG, et al. Sexual practices, sexually transmitted diseases and the incidence of anal cancer. N Engl J Med 1987;317:973–7.
Gal AA, Meyer PR, Taylor CR. Papillomavirus antigens in anorectal condyloma and carcinomas in homosexual men. JAMA 1987;257:337–10.
Palmer JC, Shepard NA, Jass JR, et al. Human papillomavirus type 16 in anal squamous carcinomas. Lancet 1988;2:42.
Penn I. Cancers of the anogenital region in renal transplant recipients: analysis of 65 cases. Cancer 1986;58:611–6.
Maleris M, Salmon RJ, Girodet J, et al. Recurrent deletions of chromosomes 11q and 3 p in anal canal carcinoma. Int J Cancer 1987;39:595–8.
Goldberg SM, Gordon PH, Nivatvongs S. Essentials of anorectal surgery. Philadelphia: JB Lippincott, 1980:161.
Morson BC, Sobin LH. Histologic typing of intestinal tumors. Geneva: World Health Organization, 1976:62–5.
Morson BC. The pathology and results of treatment of squamous cell carcinoma of the anal canal and anal margin. Proc R Soc Med 1960;53:416–20.
Moller C, Saksela E. Cancer of the anus and anal canal. Acta Chir Scand 1970;136:340–8.
Greenall MJ, Quan SH, Stearns MW, Urmacher C, Decosse J. Epidermoid cancer of the anal margin: pathologic features, treatment, and clinical results. Am J Surg 1985;149:95–101.
McConnel EM. Squamous carcinoma of the anus: review of 96 cases. Br J Surg 1970;57:89–92.
Beahrs OH, Wilson SM. Carcinoma of the anus. Ann Surg 1976;184:422–8.
Aj-Jurf AS, Turnbull RB, Fazio VW. Local treatment of squamous cell carcinoma of the anus. Surg Gynecol Obstet 1979;148:576–8.
Schraut WH, Wang CH, Dawson PJ, Block GE. Depth of invasion, location, and size of cancer of the anus dictate operative treatment. Cancer 1983;51:1291–6.
Jensen SL, Hagen K, Harling H, Shokouh-Amiri MH, Nielsen OV. Long-term prognosis after radical treatment for squamous-cell carcinoma of the anal canal and anal margin. Dis Colon Rectum 1988;31:273–8.
Pintor MP, Northover JM, Nicholls RJ. Squamous cell carcinoma of the anus at one hospital from 1948–1984. Br J Surg 1989;76:806–10.
Nigro ND, Vaitkeviceus VK. Herskovic AM. Preservation of function in the treatment of cancer of the anus. In: Vita V, ed. Important advances in oncology. Philadelphia: JB Lippincott, 1989:161–77.
Nielsen OV, Jensen SL. Basal cell carcinoma of the anus: a clinical study of 34 cases. Br J Surg 1981;68:856–7.
White WB, Schneiderman H, Sayre JT. Basal cell carcinoma of the anus: clinical and pathological distinction from cloacogenic carcinoma. J Clin Gastroenterol 1984;6:441–6.
Beck DE, Fazio VW, Jagelman DG, Lavery IC. Perianal Bowen's disease. Dis Colon Rectum 1988;31:419–22.
Ramos R, Salinas H, Tucker L. Conservative approach to the treatment of Bowen's disease of the anus. Dis Colon Rectum 1983;26:712–5.
Marfing TE, Abel ME, Gallagher DM. Perianal Bowen's disease and associated malignancies: results of a survey. Dis Colon Rectum 1987;30:782–5.
Beck DE, Fazio VW. Premalignant lesions of the anal margins. South Med J 1989;82:470–4.
Graham JH, Helwig EB. Bowen's disease and its relationship to systemic cancer. Arch Dermatol 1961;83:738–58.
Arbesman H, Ransohoff DF. Is Bowen's disease a predictor for the development of internal malignancy? A methodological critique of the literature. JAMA 1987;257:516–8.
Morson BC, Dawson MP. Gastrointestinal pathology. London: Blackwell Scientific Publications, 1972:624–5.
Berardi RS, Lee S, Chen HP. Perianal extramammary Paget's disease. Surg Gynecol Obstet 1988;167:359–66.
Jensen SL, Sjolin KE, Shokouh-Amiri MH, Hagen K, Harling H. Paget's disease of the anal margin. Br J Surg 1988;75:1089–92.
Beck DE, Fazio VW. Perianal Paget's disease. Dis Colon Rectum 1987;30:263–6.
Grodsky L. Uncommon nonkeratinizing cancers of the anal canal and perianal region. N Y State J Med 1965;65:894–901.
Helwig EG, Graham JH. Anogenital (extramammary) Paget's disease: a clinicopathologic study. Cancer 1963;16:387–403.
Armitage NC, Jass JR, Richman PI, Thomson JP, Phillips RK. Paget's disease of the anus: a clinicopathological study. Br J Surg 1989;76:60–3.
Lee SH, McGregor DH, Kuziez MN. Malignant transformation of perianal condyloma acuminatum: a case report with review of the literature. Dis Colon Rectum 1981;24:462–7.
Prioleau PG, Santa Cruz MJ, Meyer JS, Bauer WC. Verrucous carcinoma: a light and electron microscopic, autoradiographic, and immunofluorescence study. Cancer 1980;48:2849–57.
Gingrass PJ, Bubrick MP, Hitchcock CR, Strom RL. Anorectal verrucose squamous carcinoma: report of two cases. Dis Colon Rectum 1978;21:120–2.
Elliot MS, Werner ID, Immelman EJ, Harrison AC. Giant condyloma (Bushke-Loewenstein tumor) of the anorectum. Dis Colon Rectum 1979;22:497–500.
Shiels RA. A history of Kaposi's sarcoma. J R Soc Med 1986;79:532–4.
Boman BM, Moertel CG, O'Connell MJ, et al. Carcinoma of the anal canal: a clinical and pathologic study of 188 cases. Cancer 1984;54:114–25.
Greenall MJ, Quan SH, Urmacher C, DeCosse J. Treatment of epidermoid carcinoma of the anal canal. Surg Gynecol Obstet 1985;161:509–17.
Wexner SD, Milsom JW, Dailey TH. The demographics of anal cancers are changing: identification of a high-risk population. Dis Colon Rectum 1987;30:942–6.
Gordon PH. Squamous cell carcinoma of the anal canal. Surg Clin North Am 1988;68:1391–9.
Klotz RG Jr, Pamukcoglu T, Souilliard DH. Transitional cloacogenic carcinoma of the anal canal. Cancer 1967;20:1727–45.
Golden GT, Horsely JS III. Surgical management of epidermoid carcinoma of the anus. Am J Surg 1976;131:275–80.
Singh R, Nime F, Mittelman A. Malignant epithelial tumors of the anal canal. Cancer 1981;48:411–4.
Clark J, Petrelli N, Herrera L, Mittelman A. Epidermoid carcinoma of the anal canal. Cancer 1986;57:400–6.
Sawyers JL. Current management of carcinoma of the anus and perianus. Am Surg 1977;43:424–9.
Welch JP, Malt RA. Appraisal of the treatment of carcinoma of the anus and anal canal. Surg Gynecol Obstet 1977;145:837–41.
O'Brien PH, Jenrette JM, Wallace KM, et al. Epidermoid carcinoma of the anus. Surg Gynecol Obstet 1982;155:745–51.
Frost D, Richards P, Montague E. Giaceo G, Martin R. Epidermoid cancer of the anorectum. Cancer 1984;53:1285–93.
Dougherty BG, Evans HL. Carcinoma of the anal canal: a study of 79 cases. Am J Clin Pathol 1985;83:159–64.
Lopez MJ, Kraybill WG. Squamous cell cancer of the anus: the Ellis Fischel experience and current trends in management. Mo Med 1988;85:669–73.
Cantril ST, Green JP, Schall GL, Schaupp WC. Primary radiation therapy in the treatment of anal carcinoma. Int J Radiat Oncol Biol Phys 1983;9:1271–8.
Cummings BJ, Thomas GM, Keane TJ. Primary radiation therapy in the treatment of anal canal carcinoma. Dis Colon Rectum 1982;25:778–82.
Papillon J, Montbarbon JF. Epidermoid carcinoma of the anal canal: a series of 276 cases. Dis Colon Rectum 1987;30:324–33.
Hintz BL, Choryulu KK, Sudersanam A. Anal carcinoma: basic concepts and management. J Surg Oncol 1978;10:141–50.
Salmon RJ, Fenton J, Asselain B, et al. Treatment of epidermoid anal canal cancer. Am J Surg 1984;147:43–8.
Eschwege F, Lasser P, Chavy A, et al. Squamous cell carcinoma of the anal canal: treatment with external beam irradiation. Radiother Oncol 1985;3:145–50.
Papillon J. Current therapeutic concepts in management of carcinoma of the anal canal. Recent Results Cancer Res 1988;110:146–9.
Nigro ND, Vaitkevicius VK. Considine B. Combined therapy for cancer of the anal canal: a preliminary report. Dis Colon Rectum 1974;17:354–6.
Nigro ND. Multidisciplinary management of cancer of the anus. World J Surg 1987;11:446–51.
Cummings BJ, Keane TJ, Thomas GM. The results and toxicity of the treatment of anal canal carcinoma by radiation therapy or radiation therapy and chemotherapy. Cancer 1984;54:2062–8.
Flam MS, John MJ, Mowry PA, Lovalvo LJ, Ramalho LD, Wade J. Definitive combined modality therapy of carcinoma of the anus: a report of 30 cases including results of salvage therapy in patients with residual disease. Dis Colon Rectum 1987;30:495–502.
Sischy B. The use of radiation therapy combined with chemotherapy in the management of squamous cell carcinoma of the anus and marginally resectable adenocarcinoma of the rectum. Int J Radiat Oncol Biol Phys 1985;11:1587–93.
Cummings BJ. Current management of epidermoid carcinoma of the anal canal. Gastroenterol Clin North Am 1987;16:125–42.
Meeker WR Jr, Sickle-Santanello BJ, Philpott G, et al. Combined chemotherapy, radiation and surgery for epithelial cancer of the anal canal. Cancer 1986;57:525–9.
Habr-Gama A, da Silva e Sousa AH Jr, Nadalin W, Gansl R, da Silva JH, Pinotti HW. Epidermoid carcinoma of the anal canal: results of treatment by combined chemotherapy and radiotherapy. Dis Colon Rectum 1989;32:773–7.
Stearns MW, Urmacher C, Sternberg SE, Woodruff J, Attiyeh FF. Cancer of the anal canal. Curr Probl Cancer 1980;4:1–44.
Nielsen OV, Koch F. Carcinoma of the anorectal region of extramucosal origin with special reference to the anal ducts. Acta Chir Scand 1973;139:299–305.
Jensen SL, Shokouh-Amiri MH, Hagen K, Harling H, Nielsen OV. Adenocarcinoma of the anal ducts: a series of 21 cases. Dis Colon Rectum 1988;31:268–72.
Nelson RL, Prasad ML, Abcarian H. Anal carcinoma presenting as a perianal abscess or fistula. Arch Surg 1985;120:632–5.
Iversen K, Robins RE. Mucosal malignant melanoma. Am J Surg 1980;139:660–4.
Wanebo HJ, Woodruff JM, Farr GH, et al. Anorectal melanoma. Cancer 1981;47:1891–1900.
Cooper PH, Mills SE, Allen MS Jr. Malignant melanoma of the anus: report of 12 patients and analysis of 255 additional cases. Dis Colon Rectum 1982;25:693–703.
Siegal B, Cohen D, Jacob ET. Surgical treatment of anorectal melanoma. Am J Surg 1983;146:336–8.
Werdin C, Limas C, Knodell RG. Primary malignant melanoma of the rectum: evidence for origination from rectal mucosal melanocytes. Cancer 1988;61:1364–70.
Chiu YS, Unni KK, Beart RW Jr. Malignant melanoma of the anorectum. Dis Colon Rectum 1980;23:122–4.
Ward MW, Romano G, Nicholls RJ. The surgical treatment of anorectal malignant melanoma. Br J Surg 1986;73:68–9.
Boliver JC, Harris JW, Branch W, Sherman RT. Melanoma of the anorectal region. Surg Gynecol Obstet 1982;154:337–41.
Abbas JS, Karakousis CD, Holyoke ED. Anorectal melanoma: clinical features, recurrence, and patient survival. Int Surg 1980;65:423–6.
Jorge E, Harvey HA, Simonds MA, et al. Symptomatic malignant melanoma of the gastrointestinal tract. Ann Surg 1984;199:326–31.
Pyper PC, Parks TG. Melanoma of the anal canal. Br J Surg 1984;71:671–2.
Molnar L, Brezsnyak I, Daubner K, Horak E, Svastits E. Anorectal sarcomas. Acta Chir Hung 1985;26:85–91.
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Read at the meeting of The American Society of Colon and Rectal Surgeons, Toronto, Canada, June 11 to 16, 1989.
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Smith, L., Gordon, P.H. Current status—Perianal and anal canal neoplasms. Dis Colon Rectum 33, 799–808 (1990). https://doi.org/10.1007/BF02052331
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DOI: https://doi.org/10.1007/BF02052331