A Case of Neuroendocrine Carcinoma of the Anal Canal
A 62-year-old woman presented to our clinic because of anal pain was found having a palpable anal tumor by digital examination of the rectum. Colonoscopy revealed a ridging lesion with ulcer at the anal canal. A biopsy offered a diagnosis of neuroendocrine carcinoma. Apart from the anal canal tumor,...
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Published in | Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 79; no. 10; pp. 2139 - 2144 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | Japanese |
Published |
Japan Surgical Association
2018
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Subjects | |
Online Access | Get full text |
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Summary: | A 62-year-old woman presented to our clinic because of anal pain was found having a palpable anal tumor by digital examination of the rectum. Colonoscopy revealed a ridging lesion with ulcer at the anal canal. A biopsy offered a diagnosis of neuroendocrine carcinoma. Apart from the anal canal tumor, an extramural tumor of the rectum and a presacral tumor were revealed on a CT scan. PET-CT scan showed abnormal uptakes of FDG in all the three tumors. Lymph node metastases of anal canal carcinoma were diagnosed, and abdominoperineal resection + D3 lymph node dissection was performed. The resected specimen included the anal canal tumor with the size of 25 × 25 mm in diameter. Histopathologically the tumor was substantially composed of proliferation of large oval-shaped cells with a large N/C ratio and the progression was rated as Stage IIIb. On immunohistochemistry, the anal canal tumor was strongly positive for synaptophysin and positive for chromogranin A, with the Ki-67 positive rate of 60%. Furthermore, we also confirmed well-differentiated adenocarcinoma and villous adenoma in the oral margin of the tumor. Neuroendocrine carcinoma arisen in the anal canal was thus diagnosed. We performed mFOLFOX (6) as adjuvant chemotherapy. |
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ISSN: | 1345-2843 1882-5133 |
DOI: | 10.3919/jjsa.79.2139 |