Abstract
Bowen's disease of the anus is usually treated by wide local excision including macroscopic normal areas if random biopsies show dysplasia. Skin grafting will often be necessary, since areas of microscopic dysplasia may be found at a considerable distance from the gross affected site. In this study of 11 patients with Bowen's disease of the anus we report the results of a more conservative approach. All patients were treated by local excision of the gross affected areas only, and none of the patients required skin grafting. Seven patients were followed for a median of 34 months without macroscopic recurrence, including 3 patients with histologically proven dysplasia in the resection margins. Two patients, one with and one without dysplasia in the resection margins, developed recurrence within a year. One patient with an area of invasive carcinoma was first treated by local excision, but required an abdominoperineal excision 3 months later. One patient lost to follow-up had invasive carcinoma after 3 years. It is concluded that a conservative surgical approach in Bowen's disease of the anus is justified, provided the patients are followed closely.
Similar content being viewed by others
References
Harrison EG Jr, Beahrs OH, Hill JR (1966) Anal and perianal malignant neoplasms: pathology and treatment. Dis Colon Rectum 9:255–267
Strauss RJ, Fazio VW (1979) Bowen's disease of the anal and perianal area. Am J Surg 137:231–234
Seckel BR (1985) Skin grafts for circumferential coverage of perianal wounds. Surg Clin North Am 65:365–371
Reynolds VH (1984) Preservation of anal function after total excision of the anal mucosa for Bowen's disease. Ann Surg 199:563–568
Gordon BS (1956) Unsuspected lesions in anal tissue removed for minor conditions. Arch Surg 73:741–746
Grodsky L (1967) Unsuspected anal cancer discovered after minor anorectal surgery. Dis Colon Rectum 10:471–478
Scoma JA, Levy EI (1975) Bowen's disease of the anus: report of two cases. Dis Colon Rectum 18:137–140
Fenger C (1987) The anal transitional zone. Acta Path Microbiol Immunol Scand [Suppl] 289; 95:32–35
Goligher J (1984) Surgery of the anus, colon and rectum, 5th edn. Bailliére Tindall, London
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Rasmussen, O.Ø., Christiansen, J. Conservative management of Bowen's disease of the anus. Int J Colorect Dis 4, 164–166 (1989). https://doi.org/10.1007/BF01649695
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01649695