[A case of anal canal cancer with pagetoid spread and inguinal lymph node involvement].
We report a rare case of pSM anal canal cancer with pagetoid spread and inguinal lymph node involvement. A 74-year- old woman was admitted to our hospital complaining of a perianal erythematous lesion. Preoperative skin biopsy revealed an infiltration of pagetoid cells and signet-ring cell carcinoma cells, which were positive for CK20 and negative for GCDFP 15 by immunohistochemical stainings. Colonoscopy demonstrated an elevated lesion located just above the dentate line. Total pelvic exenteration with lateral and inguinal lymph node dissection followed by skin reconstruction with gluteal thigh flap was performed. Histological examination of the anal tumor revealed moderately differentiated adenocarcinoma infiltrating the submucosa( pSM) with left lymph node involvement. We should note that pSM anal canal cancer with pagetoid spread might cause inguinal lymph node metastasis, even though such cases have rarely been reported in the literature.
Dept. of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University.
Tetsuya
T
Ito
Keiichiro
K
Ishibashi
Yusuke
Y
Tajima
Satoshi
S
Hatano
Jun
J
Sobajima
Tomonori
T
Ohsawa
Norimichi
N
Okada
Kensuke
K
Kumamoto
Norihiro
N
Haga
Hideyuki
H
Ishida
D000368:Aged; D001005:Anus Neoplasms / Q000473:pathology* / Q000601:surgery; D001706:Biopsy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D009361:Neoplasm Invasiveness; D010145:Paget Disease, Extramammary / Q000473:pathology* / Q000601:surgery