Anal gland carcinoma

Abstract

BACKGROUND Anal gland carcinoma is a rare entity. The authors conducted a joint study of cases coded as definite or possible anal gland carcinoma from the archives of the Armed Forces Institute of Pathology and the Canadian Reference Center for Cancer Pathology. METHODS Seven cases of potential anal gland carcinoma were identified from the Canadian files and 12 from the Armed Forces Institute of Pathology archives. Of these 19 cases, 14 had adequate material to allow clinical, histologic, and immunohistochemical analysis. RESULTS Seven of these 14 cases met a modified World Health Organization (WHO) definition of anal gland carcinoma. The mean age of these patients was 66 years (range, 60–72 years), with a male‐to‐female ratio of 6:1. The tumors were composed of haphazardly dispersed, small glands with scant mucin production that invaded the wall of the anorectal area with no obvious intraluminal component observed clinically or microscopically. Immunohistochemical studies were performed on all seven of these cases, revealing cytokeratin (CK) 7+/CK 20− expression in six cases, and CK 7+/CK 20+ expression in one case. The remaining seven cases showed no intraluminal component but did not meet a modified WHO definition of anal gland carcinoma. This group included three mucinous adenocarcinomas (two clinically arising in anal fistulas), all of which were CK 7+/CK 20+, and a rectal‐type adenocarcinoma that was CK 7−/CK 20+. There was also a tumor interpreted as probable rectal‐type adenocarcinoma that was CK 7+/CK 20+, and a tumor interpreted as probable squamous cell carcinoma that was CK 7−/CK 20−. The seventh tumor in this group, which could not be classified, was CK 7+/CK 20−. CONCLUSIONS A useful and discriminating definition of anal gland carcinoma is an anal canal tumor composed of haphazardly dispersed, small glands with scant mucin production invading the wall of the anorectal area without an intraluminal component. The glands are positive for CK 7. Cancer 2001;92:2045–9. © 2001 American Cancer Society.

A CARE-compliant article: a case report of primary adenocarcinoma of the anal glands

“…According to Hobbs et al, a primary intramural anal canal tumor composed of small dispersed glands could be considered as an anal gland carcinoma even without examination of the expression of CK. [15] In our case, the cancer cells were small tubular or strip-like, disorderly distributed, without secreted mucus in the cytoplasm, and invading the muscular layer of the anal canal, as observed after staining with hematoxylin and eosin (HE) (Fig. 2).…”

A case of metastatic carcinoma of anal fistula caused by implantation from rectal cancer

“…Loy et al [7] reported that the vast majority of colon cancers (80 %) are CK7 (−)/CK20 (+) while some (16 %) are CK7 (+)/CK20 (+) and a few (4 %) are CK7 (−)/CK20 (−). In six of seven cases of primary cancer arising from an anal fistula, those cancers were CK7 (+)/CK20 (−) [8]. In instances where colon cancer and cancer arising from an anal fistula are both present, the primary cancer must be differentiated from metastases.…”

Synchronous rectal adenocarcinoma and anal canal adenocarcinoma

“…Primary adenocarcinoma of the anal glands is extremely uncommon. It is composed of small acini and tubules originating from gland/ducts that open onto the mucosal surface and infiltrate the surrounding tissues [18,19]. In the present case, the second tumor was located within the middle zone with normal squamous mucosa.…”

“…Among the primary colonic adenocarcinomas, 75%-95% has a CK7-negative and CK20-positive phenotype [20][21][22]. In 2001, Hobbs et al reported that coordinated expression of cytokeratins (CK) 7 and CK 20 might help distinguish anal gland carcinomas from the rectal-type carcinomas and the mucinous adenocarcinomas as six of their seven cases of anal gland carcinoma had shown CK7+/CK20-expression [19]. They concluded that CK7 is a useful and discriminating marker of anal gland carcinoma.…”