| Theme |
Current Topics on Anorectal Disorders |
| Title |
Malignant Neoplasms in Perianal Region Excluding Adenocarcinoma |
| Author |
Ken-ichi Takahashi |
Department of Surgery, Division of Biological Regulation and Oncology, Tohoku University Graduate School of Medicine |
| Author |
Yuji Funayama |
Department of Surgery, Division of Biological Regulation and Oncology, Tohoku University Graduate School of Medicine |
| Author |
Kouhei Fukushima |
Department of Surgery, Division of Biological Regulation and Oncology, Tohoku University Graduate School of Medicine |
| Author |
Iwao Sasaki |
Department of Surgery, Division of Biological Regulation and Oncology, Tohoku University Graduate School of Medicine |
| Author |
Katsuko Kikuchi |
Department of Dermatology, Tohoku University Graduate School of Medicine |
| Author |
Takuya Moriya |
Department of Pathology, Tohoku University Hospital |
| [ Summary ] |
Various kinds of malignant neoplasms can develop in the perianal region as well as adenocarcinoma. Because they often mimic eczema or hemorrhoids, biopsies are needed for diagnosis. Appropriate treatment is important for each type of neoplasm. For Paget's disease of perianal skin origin, the prognosis is good with wide local excision of tumors. On the other hand, Pagetoid spread of adenocarcinoma of the anal canal must be treated with abdominoperineal resection of the rectum. Therefore, differential diagnosis of these two different clinical conditions is very important. Both Bowen's disease and basal cell epithelioma are treated with local excision of tumors and the prognosis is good. Malignant melanoma may easily metastasize and the prognosis is very poor, so early diagnosis is needed. Melanoma is treated by abdominoperineal resection of the rectum with sufficient lymphnode dissection. Malakoplakia is a rare form of chronic inflammatory granuloma. It should be noted that nearly half of all patients with malakoplakia also have malignant neoplasms such as colorectal carcinoma. |