A Case of Anal Gland Carcinoma Accompanied by Pagetoid Spread

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  • Ｐａｇｅｔｏｉｄ　ｓｐｒｅａｄをともなった肛門腺癌の１例

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Rectal or anal canal cancer, accompanied by pagetoid spread (PS), is a rare case. We recently encountered a 65-year-old woman with this condition. The woman, primarily complaining of anal pain on defecation, was found to have a two-peak elevated lesion in the anal duct in the vicinity of the dentate line and underwent transanal resection of the lesion. Because of the stump was cancer cell positive, she later underwent abdominoperineal excision of the rectum. Pathological and immunohistochemical examinations allowed a diagnosis of primary adenocarcinoma of the anal canal, originating from the anal gland. Her postoperative course was uneventful. To date, 62 cases of rectal or anal canal cancer accompanied by PS have been reported in Japan, including 19 cases where the cancer originated from the anal gland. The cancer was often at advanced stages among the cases reported to date. In the present case, the cancer was detected at an early stage, and continuity of the carcinoma in situ of the anal gland to PS was demonstrated for the first time in Japan. Our experience with the present case strongly suggests that PS begins with carcinoma in situ of the anal gland.<br>

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