A case report of anal canal cancer with pagetoid spread requiring differential diagnosis

Yukimoto, Ryohei; Fujino, Shiki; Miyoshi, Norikatsu; Ogino, Takayuki; Takahashi, Hidekazu; Uemura, Mamoru; Tanemura, Atsushi; Matsuda, Chu; Yamamoto, Hirofumi; Mizushima, Tsunekazu; Doki, Yuichiro; Eguchi, Hidetoshi

doi:10.1016/j.ijscr.2020.09.048

Cited by 2 publications

(5 citation statements)

References 14 publications

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“…Absolutely, transanal local resection with wide skin excision might be considered as an initial operation and additional resection can be planned if needed. 11,20,21 However, it is considered that the primary lesion was not ben detected preoperatively and detected by histological exploration, like as Case 2. Additionally, PS skip lesions which are lacking connection within the epidermis was reported.…”

Section: Discussionmentioning

confidence: 99%

“…Although a primary tumorous lesion is usually obvious in most instances of PS, this was not the case in our patients. A search of the PubMed and MEDLINE databases using “pagetoid spread” and “no tumorous lesion” as key words resulted in 16 case reports of nonmass‐forming type anorectal cancer with PS 9–24 (Table 1). Interestingly, all of them were reported from Japan and the reason is uncertain and warrants further study.…”

Section: Discussionmentioning

confidence: 99%

“…More patients could have potentially residual carcinoma in situ like Case 2 if only local excision was performed for them. Absolutely, transanal local resection with wide skin excision might be considered as an initial operation and additional resection can be planned if needed 11,20,21 . However, it is considered that the primary lesion was not ben detected preoperatively and detected by histological exploration, like as Case 2.…”

Section: Discussionmentioning

confidence: 99%

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Nonmass‐forming type anorectal cancer with pagetoid spread: A report of two cases

Yamamoto

Mizuuchi

Tamura

et al. 2023

Asian J Endoscop Surgery

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Pagetoid spread (PS) of anorectal cancer is relatively rare and associated with poor prognosis. While a primary tumorous lesion is usually obvious in most PS cases, we experienced two cases of nonmass‐forming type anorectal cancer with PS. It remains challenging to decide strategies. In both cases, histological findings of a perianal skin biopsy showed proliferation of atypical cells that were positive for cytokeratin (CK) 7, CK20, and caudal type homeobox 2 and negative for Gross cystic disease fluid protein 15, suggesting PS. Abdominoperineal resection (APR) with extensive anal skin resection was performed in both patients. The pathological diagnosis in each was nonmass‐forming type anorectal cancer with PS. Neither has experienced recurrence in postoperative courses. Even nonmass‐forming type anorectal cancer with PS could have high malignant potentials. APR with lymph nodes dissection and wide skin excision and regular surveillance might be necessary.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Nonmass‐forming type anorectal cancer with pagetoid spread: A report of two cases

Yamamoto

Mizuuchi

Tamura

et al. 2023

Asian J Endoscop Surgery

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Section: Staging Classification and Treatment Outcomementioning

confidence: 99%

“…The distinction between PPD with and without underlying anorectal cancer is essential [3,[23][24][25] because of the differences in treatment methods and the prognosis [4]. Due to the rarity of PPD, few cases have been reported [24][25][26][27], and long-term outcomes of treatment for PS are unknown. This study aims to analyze the clinical and pathological features of perianal Paget's disease (PPD) and to explore rational treatment options and follow-up for this disease.…”

Section: Staging Classification and Treatment Outcomementioning

confidence: 99%

A review of 14 cases of perianal Paget’s disease: characteristics of anorectal cancer with pagetoid spread

et al. 2023

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Background Perianal Paget’s disease (PPD) is an intraepithelial invasion of the perianal skin and is frequently associated with underlying anorectal carcinoma. The relatively rare nature of this disease has made it difficult to develop treatment recommendations. This study aims to analyze the clinical and pathological features of perianal Paget’s disease (PPD) and to explore rational treatment options and follow-up for this disease. Methods The National Cancer Center Hospital database was searched for all cases of perianal Paget’s disease diagnosed between 2006 and 2021. In the 14 patients identified, we reviewed the diagnosis, management, and outcomes of adenocarcinoma with pagetoid spread, including suspected or recurrent cases. Results All 14 cases met the inclusion criteria. The median follow-up period after diagnosis was 4.5 (range, 0.1–13.0) years. Pagetoid spread before initial treatment was suspected in 12 cases (85.7%). Underlying rectal cancer was identified in 6 cases, and no primary tumor was detected in the other 6 cases. Seven patients had recurrent disease, with the median time to recurrence of 34.6 (range, 19.2–81.7) months. The time to the first relapse was 3 months, and that to the second relapse was 6 months. The overall 5-year survival rate was 90.0%. Conclusions Endoscopic and radiologic evaluation, as well as immunohistologic examination, should be performed. is to differentiate PPD with and without underlying anorectal carcinoma. The time to first recurrence varies widely, and long-term and regular follow-up for more than 5 years is considered necessary for local recurrence and distant metastasis.

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A case report of anal canal cancer with pagetoid spread requiring differential diagnosis

Cited by 2 publications

References 14 publications

Nonmass‐forming type anorectal cancer with pagetoid spread: A report of two cases

Nonmass‐forming type anorectal cancer with pagetoid spread: A report of two cases

A review of 14 cases of perianal Paget’s disease: characteristics of anorectal cancer with pagetoid spread

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