title: Adenocarcinoma in a hemorrhoidectomy specimen: case report and review of the literature.
abstract: Our purpose is to report a case of unexpected anal adenocarcinoma found in a hemorrhoidectomy specimen. A review of the literature, with emphasis on extramucosal anal adenocarcinoma as a pathologic entity, is included. Our patient presented with a 2-year history of grade III prolapsing internal hemorrhoids. A hemorrhoidectomy was performed and gross examination of the specimen was unremarkable. The pathologic evaluation revealed microinvasive well-differentiated adenocarcinoma at the squamocolumnar junction. There was neither an apparent connection with the overlying mucosa nor an in situ component. A metastatic workup ruled out any other site of malignancy. At follow-up 18 months after surgery, no evidence of malignancy or recurrence was observed. An unexpected extramucosal anal adenocarcinoma in a hemorrhoidectomy specimen is a very exceptional finding. Review of the literature does not support routine histopathological examination of hemorrhoidectomy specimens.
authors.affiliation: Department of Surgery, University of Tennessee Medical Center at Knoxville, 37920-6999, USA.
authors.forename: C H
authors.initials: CH
authors.lastname: Timaran
authors.forename: Y P
authors.initials: YP
authors.lastname: Sangwan
authors.forename: J A
authors.initials: JA
authors.lastname: Solla
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000473:pathology; D001005:Anus Neoplasms / Q000150:complications* / Q000473:pathology; D006484:Hemorrhoids / Q000150:complications* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged