Diagnosis of Malignant Tumor of the Anal Canal

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  • 肛門管悪性腫瘍の診断

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<p>Early diagnosis of anal canal cancer is important because the degree of progression greatly affects prognosis and quality of life. We reviewed the current status and problems of definitive diagnosis in 47 cases of malignant tumors of the anal canal diagnosed at our hospitals. The chief complaints were bleeding in 21 cases, anal pain in 20, tumor in 17, disordered defecation in 4, abdominal symptoms in 3, and itching in 2. The duration from symptom onset to consultation was 6 months or longer in 16 cases. Histological diagnoses included adenocarcinoma in 22 cases, squamous cell carcinoma in 18, basal cell carcinoma in 2, malignant melanoma in 2, and endocrine cell carcinoma, Paget's disease and malignant lymphoma in 1 each. Definitive diagnosis was made by digital examination in 24 cases, endoscopy in 10, examination under anesthesia in 9, and pathology of surgical specimens in 4. Eight cases required more than 1 month for definitive diagnosis. By histological type, most adenocarcinomas were mass lesions with ulceration and could be diagnosed by digital examination at the first visit. On the other hand, squamous cell carcinoma presented a variety of macroscopic findings and definitive diagnosis tended to be delayed. For early diagnosis of malignant tumors of the anal canal, anorectal examination should always be performed with the possibility of malignant disease in mind. In addition, aggressive tissue biopsy, endoscopy and examination under anesthesia should be considered in case of atypical findings.</p>

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