1/83. Primary anorectal malignant melanoma: report of a case.Primary anorectal malignant melanoma is a fairly uncommon but highly malignant disease. This disease is sometimes mistaken for such benign conditions as either a hemorrhoid or rectal polyp. We herein describe a case of early primary malignant melanoma of the anal canal. In this case, magnetic resonance (MR) imaging was found to be useful for diagnosing the melanotic melanoma. We especially emphasize the usefulness of a fat-saturation MR image in distinguishing melanotic melanoma from other rectal tumors.- - - - - - - - - - ranking = 1keywords = canal (Clic here for more details about this article) |
2/83. leukoplakia of the anal canal.Two cases of leukoplakia of the anal canal are presented, with illustrations of the typical gross and microscopic appearance. The lesions were asymptomatic, and were discovered by routine rectal examination. Histological findings included hyperkeratosis and acanthosis extending cephalad from the anal verge to the dentate line. Followup after 3 and 15 years revealed no evidence of dysplastic changes, and a review of the literature did not uncover any reported cases with dysplasia or with documented evolution to malignancy. There is little evidence that leukoplakia of the anal canal is premalignant but patients should be followed carefully, since the natural history of this rare lesion is unknown.- - - - - - - - - - ranking = 6keywords = canal (Clic here for more details about this article) |
3/83. Treatment of grade 3 anal intraepithelial neoplasia by complete anal mucosal excision without fecal diversion: report of a case.PURPOSE: The aim of this study was to remove completely the risk of malignant transformation without permanent or temporary fecal diversion in a patient with extensive anal intraepithelial neoplasia. methods: All anal canal mucosa and the lowest 1.5 cm of rectal mucosa were excised and the adjacent rectal mucosa and submucosa advanced to the anal verge skin. RESULTS: The patient achieved normal continence within a month after the operation. Multiple anal canal biopsies at 12 months after the operation revealed normal rectal mucosa. CONCLUSIONS: Total anal mucosal excision offers a relatively simple means of removing the malignant risk of anal intraepithelial neoplasia without fecal diversion in selected patients.- - - - - - - - - - ranking = 2keywords = canal (Clic here for more details about this article) |
4/83. Is Hartmann's procedure safe in Crohn's disease? Report of three cases.INTRODUCTION: Crohn's disease-associated colorectal cancer may occur in an area of defunctioning bowel. Some patients with Crohn's colitis undergo subtotal colectomy, ileostomy, and low Hartmann's procedure in an effort to preserve the rectum. This procedure has also been advocated for patients with severe anorectal Crohn's disease, in whom nonhealing of the perineal wound after proctectomy occurs with alarming frequency. The authors present a review of the literature and three cases of cancer developing in the defunctioning rectal stump despite surveillance proctoscopy. methods: Twenty-five patients underwent low Hartmann's procedure for severe anorectal Crohn's disease. Surveillance proctoscopy was performed as follow-up. Development of cancer in the rectal remnant or anus or recurrence of symptoms was managed by resection and adjuvant therapy. RESULTS: One patient developed squamous-cell carcinoma of the anal canal, underwent resection and adjuvant therapy, and was disease free at the time of this study. Two patients developed adenocarcinoma of the rectum. Both underwent resection and adjuvant therapy. One patient died and the other developed a recurrence. CONCLUSIONS: The authors recommend interval perineal proctectomy in all patients undergoing low Hartmann's procedure for severe anorectal Crohn's disease in whom rectal preservation is not possible. Regularly scheduled interim surveillance proctoscopy performed every two years, with biopsies of macroscopically normal-appearing and abnormal-appearing rectal mucosa and curetting of fistulous tracts, is also recommended to decrease the possibility of missing occult malignancies.- - - - - - - - - - ranking = 1keywords = canal (Clic here for more details about this article) |
5/83. Radical excision of multifocal anal intraepithelial neoplasia: report of a case.PURPOSE: The aim of this study was to describe the technique of radical excision of multifocal anal intraepithelial neoplasia and discuss controversial issues surrounding the management of this condition. METHOD: We describe the case of a 31-year-old female with previous vulval warts, vulval squamous carcinoma, and recent immunosuppression who had widespread anal intraepithelial neoplasia excised, and the resulting defect was split-skin grafted, including the anal canal. RESULTS: Excision and split-skin grafting was successful in removing the disease and left a satisfactory cosmetic and functional result. CONCLUSION: Diffuse, high-grade, anal intraepithelial neoplasia is rare. Excision of these lesions remains controversial but may be the best option.- - - - - - - - - - ranking = 1keywords = canal (Clic here for more details about this article) |
6/83. Solitary neurofibroma of the anal canal: report of two cases.Neurofibromas are benign nerve sheath tumors commonly found in patients afflicted with neurofibromatosis-1. In the absence of multiple neurofibromas or a diagnosis of neurofibromatosis-1, neurofibromas are referred to as solitary and have been reported to involve the skin, subcutaneous tissue, deep soft tissue, and viscera of almost all areas of the body. A neurofibroma involving the anal canal is a rare entity, with only one report in the literature. We present two cases in which large masses involving the anal canal of elderly females were locally resected and proved to be neurofibromas by histopathology. Although rare, these tumors should be considered in the differential diagnosis of patients presenting with an anal mass, because resection alone is the treatment of choice.- - - - - - - - - - ranking = 6keywords = canal (Clic here for more details about this article) |
7/83. Adjuvant interstitial brachytherapy in a case of anorectal melanoma.PURPOSE: A locally resectable case of anorectal melanoma is reported. In order to prevent local recurrence, interstitial brachytherapy was used. METHOD: A 45 years old emaciated female presented with a 8 x 6 x 6 cm, hard, mobile, intraluminal mass in the anal canal and rectum, biopsy revealed malignant melanoma. As the mass was locally resectable, wide local excision of the tumour was carried out. She was subsequently given interstitial brachytherapy with Caesium--137 implants at tumour bed, not described so far in literature. Six months later her general condition had improved but abdomino-perineal resection was necessitated due to presence of extra-rectal metastasis. RESULTS: Patient is in our follow-up for 36 months now and doing well. CONCLUSION: Supplementation of interstitial brachytherapy after local resection of ano-rectal melanoma may help to prevent local recurrence.- - - - - - - - - - ranking = 1keywords = canal (Clic here for more details about this article) |
8/83. An unusual late radiotherapy-related complication requiring surgery in anal canal carcinoma.We herein describe an unusual late radiation-related complication requiring surgery in a 60-year-old male affected by anal epidermoid carcinoma. The patient presented with obstructed defecation and ulcerated perianal lesions. The perianal biopsies were positive for anal squamous carcinoma. Transanal diagnostic investigations could not be performed because of anal stenosis. Computed tomography detected left inguinal lymphadenopathy and a nonhomogeneous presacral mass, infiltrating the rectal wall, the coccyx, and the sacrum. The patient underwent a colostomy, infusion of cisplatin and 5-fluorouracil, and irradiation of the pelvis, perianal region, and inguinal lymph nodes. In June 1997 the patient complained of the onset of continuous pain at the genitalia, and for penis necrosis he underwent penis amputation. The histologic examination was conclusive for postradiotherapy thrombosis. This complication could strengthen the hypothesis of vasculoconnective damage as the origin of long-term effects of radiotherapy. Probably the minimal dose in transit volume could not be achieved. Careful evaluation in choosing the treatment scheme is necessary if different options are available.- - - - - - - - - - ranking = 4keywords = canal (Clic here for more details about this article) |
9/83. anal canal squamous-cell carcinoma in situ, clearly demonstrated by indigo carmine dye spraying: report of a case.To our knowledge, there has been no report of the use of indigo carmine dye spraying for the diagnosis of intraepithelial neoplasia. An asymptomatic 58-year-old female was referred to our hospital with a diagnosis of squamous-cell carcinoma in the anal canal. After indigo carmine dye spraying the margin and surface appearance of the lesion could be clearly defined. The lesion was completely removed by transanal resection. Final histologic diagnosis was squamous-cell carcinoma in situ with koilocytosis. Our case suggests that indigo carmine could be useful for the diagnosis of intraepithelia neoplasia.- - - - - - - - - - ranking = 5keywords = canal (Clic here for more details about this article) |
10/83. Chemoradiation therapy for squamous cell carcinoma of anal canal cancer: report of a case.We report a case of anal canal cancer in a 65-year-old woman who had complained of bloody stool. physical examination revealed a 2.5 cm ulcerated tumor in the anterior wall of the anal canal astride the dentate line. Histological examination of biopsy specimens confirmed the diagnosis of moderately differentiated squamous cell carcinoma. Chemoradiation therapy included whole pelvic irradiation amounting to 4140 cGy followed by conformal boost irradiation of 2000 cGy and 5-fluorouracil div 750 mg/24 hr 3 days, mitomycin C iv 10 mg day 1, and cisplatinum div 50 mg day 2. Six weeks later the tumor had completely regressed, and there was no evidence of recurrence 21 months later. Her anorectal function was retained.- - - - - - - - - - ranking = 6keywords = canal (Clic here for more details about this article) |
| | Next -> |