Japanese

Invasive Squamous Cell Carcinoma of the Anal Canal Broadly Involving the Submucosal Portion of the Rectum, Report of a Case Daisuke Yoshimura 1 , Shunsuke Takahashi 1,2 , Shin-ichiro Shimamatsu 3 , Michiko Ehara 4 , Minako Hirahashi 2 , Yoshinao Oda 2 , Akihiko Nakashima 4 , Hiroshi Matsuura 3 , Toshiaki Ochiai 1 , Teppei Kabemura 1 , Kazuhiko Nakamura 5 1Department of Internal Medicine, Saiseikai Fukuoka General Hospital, Fukuoka, Japan 2Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan 3Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan 4Department of Pathology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan 5Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan Keyword: 肛門管扁平上皮癌 , 拡大内視鏡 , NBI , ヒトパピローマウイルス , 粘膜下浸潤 pp.1208-1216
Published Date 2013/7/25
DOI https://doi.org/10.11477/mf.1403113902
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 An 82-year old woman suffering from anal pain and bleeding was referred to our hospital. Endoscopy revealed a white lobulated tumor on the anterior wall of the anal canal, and the tumor broadly involved the distal end of the rectum. The anterior wall of the rectum showed marked thickening, diffuse reddish mucosa, and multifocal epithelial defects in which small white nodules were observed. Magnifying endoscopic observation with NBI(narrow band imaging)was useful because the surface of both the anal canal tumor and the rectal white nodules in the mucosal epithelial defects showed irregularly dilated and aggregated microvessels, which resembled those of invasive esophageal cancer. Biopsy specimens from them showed squamous cell carcinoma. Surgical specimen revealed invasive squamous cell carcinoma of the anal canal, and the tumor diffusely involved in the submucosal portion of the rectum to the posterior wall of the vagina. The tumor also had invaded upwardly to the rectal mucosa, which caused scattering epithelial defects and exposure of the tumor itself. The anal canal tumor was surrounded by squamous cell carcinoma in situ with koilocytosis-like atypia. The patient had been treated for uterine cervical cancer(squamous cell carcinoma)40 years previously, thus these findings suggest that both of her metachronous cervical and anal canal cancers may be strongly related to oncogenic HPV(human papilloma virus)infection.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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