Anorectal Carcinomas of Extra-Mucosal Origin

Mucinous adenocarcinoma associated with fistula in ano: report of a case

“…Zimberg and Kay [10] found that local excision of adenocarcinoma in this region was followed by a high recurrence rate. Treatment is by abdominoperineal resection, which can be curative if the diagnosis is made early [7].…”

Synchronous mucinous adenocarcinoma of the recto sigmoid revealed by and seeding an anal fistula. (A case report and review of the literature)

“…Dukes and Calvin suggested that such tumors arise via an unusual duplication of the mucosa [27] . Zimberg and Kay showed that even for tumors arising from anal fistula the most common site is the anal gland [28] . Also Nielsen and Koch report the same theory [29] Taniguchi et al reported that these tumors originate from the rectal mucosal cells that migrate into the anal canal [30] .…”

Perianal mucinous adenocarcinoma

“…The broadest definition of anal adenocarcinoma is attributed to Zimberg and Kay [8], who suggested that anal canal adenocarcinoma with little to no mucosal involvement compared with submucosal or lateral involvement should be considered anal duct in origin. At the other end of the spectrum, the strictest criteria have been put forth by Fenger and Morson [9] and include: (1) origin at site where anal glands are present, (2) exclusion of mucosal origin, anal fistulas, gut duplications, and metastatic deposits, (3) transition from normal anal gland to carcinoma preferably with interposed dysplastic epithelium, and (4) a distinctive microscopic picture consistent with an anal gland origin.…”