Adenocarcinoma of the anal ducts

Abstract

The records of 21 patients treated for adenocarcinoma of the anal ducts between 1943 and 1982 were reviewed. The patients were followed until death or current status in April 1987. The median follow-up period was eight months (range, 3 to 144 months). Fifteen patients had an erroneous diagnosis made at first physician visit resulting in a median doctor's delay of 14 months (range, 3 to 24 months) before correct treatment was carried out. Nine of the tumors were localized perianally (ischiorectal space), seven anally, and five in a fistula-in-ano. Tumors localized anally were significantly smaller and had a significantly shorter history than perianally or fistula-in-ano localized tumors (P less than .05 for each localization). Three patients with anal tumors had their diagnosis made accidentally by routine histologic examination of an excised hemorrhoid. First examination revealed distant metastases in 13 patients and follow-up examination revealed regional or distant metastases in seven patients. Modes of treatment were wide local excision (N = 3), abdominoperineal resection (N = 3), colostomy (N = 9), and radiotherapy (N = 2). Twenty of the 21 patients died within 18 months due to the cancer. One long-term survivor was observed; the patient was alive 12 years after local excision of the tumor without evidence of recurrent disease. The crude five- and 10-year survival was only 4.8 percent.

Malignant tumors of the anal canal

“…The reported prognosis has been uniformly poor for this group of patients. 34,36 Surprisingly, our survival and recurrence rates at 5 years were 63% and 21%, respectively. Two factors may be responsible for the high survival rate: the majority of our tumors (78%) were small (Ͻ5 cm), and chemoradiotherapy was used either preoperatively or postoperatively for larger tumors (Ͼ5 cm).…”

Perianal mucinous adenocarcinoma

“…Nevertheless, we feel that, based on the histologic and anatomic evidence, this patient's tumor was best classified as an anal gland adenocarcinoma. As was the case with our patients, the majority of patients in previous reports have had extensive disease at the time of presentation, making successful treatment difficult [10]. The standard treatment option for these patients has been surgical.…”

Mucinous adenocarcinoma derived from chronic perianal fistulas: report of a case and review of the literature

“…A review of the literature revealed fewer than 120 cases of this disease (Table 1) [2][3][4][5][6][7][8][9][10][11][12][13][14]. Early diagnoses is difficult, as the symptoms are nonspecific and appear late.…”