Anal gland adenocarcinoma in situ with pagetoid spread: a case report

Abstract Background Anal gland carcinoma with perianal Paget’s disease is rare, and anal gland carcinoma in situ is extremely rare. No cases of anal gland carcinoma in situ with pagetoid spread have been previously reported. Case presentation Physical examination in a 75-year-old woman revealed an e...

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Main Authors: Kohei Ishioka, Fumikazu Koyama, Hiroyuki Kuge, Takashi Inoue, Shinsaku Obara, Takayuki Nakamoto, Yoshiyuki Sasaki, Yasuyuki Nakamura, Maiko Takeda, Chiho Ohbayashi, Masamitsu Kuwahara, Masayuki Sho
Format: Article
Language:English
Published: Japan Surgical Society 2018-06-01
Series:Surgical Case Reports
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Online Access:http://link.springer.com/article/10.1186/s40792-018-0469-5
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author Kohei Ishioka
Fumikazu Koyama
Hiroyuki Kuge
Takashi Inoue
Shinsaku Obara
Takayuki Nakamoto
Yoshiyuki Sasaki
Yasuyuki Nakamura
Maiko Takeda
Chiho Ohbayashi
Masamitsu Kuwahara
Masayuki Sho
author_facet Kohei Ishioka
Fumikazu Koyama
Hiroyuki Kuge
Takashi Inoue
Shinsaku Obara
Takayuki Nakamoto
Yoshiyuki Sasaki
Yasuyuki Nakamura
Maiko Takeda
Chiho Ohbayashi
Masamitsu Kuwahara
Masayuki Sho
author_sort Kohei Ishioka
collection DOAJ
description Abstract Background Anal gland carcinoma with perianal Paget’s disease is rare, and anal gland carcinoma in situ is extremely rare. No cases of anal gland carcinoma in situ with pagetoid spread have been previously reported. Case presentation Physical examination in a 75-year-old woman revealed an erythematous, inflamed, perianal skin lesion. Neither colposcopy, cystoscopy, colonoscopy, computed tomography, nor magnetic resonance imaging showed evidence of malignant genitourinary or gastrointestinal lesions. Histopathological examination of a biopsy specimen showed many Paget’s cells in the perianal skin lesion and no malignant cells in the rectal or vaginal mucosa. Therefore, primary extramammary Paget’s disease of the anogenital region was suspected, and we performed anus-preserving wide local excision. However, immunohistochemistry revealed a diagnosis of secondary extramammary Paget’s disease due to adenocarcinoma arising from the anal gland. We therefore proceeded with a radical operation. Histopathological examination showed no residual cancer cells. The final diagnosis was anal gland adenocarcinoma in situ with pagetoid spread in the perianal skin. Conclusions This is the first case report of anal gland adenocarcinoma in situ with pagetoid spread. We recommend immunohistochemical analysis of biopsy and locally resected specimens to obtain an accurate diagnosis and determine the appropriate treatment when there is no visible tumor.
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series Surgical Case Reports
spelling doaj-art-ce79d889b754490386bcbb7e3304f7e52025-08-20T03:57:44ZengJapan Surgical SocietySurgical Case Reports2198-77932018-06-01411510.1186/s40792-018-0469-5Anal gland adenocarcinoma in situ with pagetoid spread: a case reportKohei Ishioka0Fumikazu Koyama1Hiroyuki Kuge2Takashi Inoue3Shinsaku Obara4Takayuki Nakamoto5Yoshiyuki Sasaki6Yasuyuki Nakamura7Maiko Takeda8Chiho Ohbayashi9Masamitsu Kuwahara10Masayuki Sho11Department of Surgery, Nara Medical UniversityDepartment of Surgery, Nara Medical UniversityDepartment of Surgery, Nara Medical UniversityDepartment of Surgery, Nara Medical UniversityDepartment of Surgery, Nara Medical UniversityDepartment of Surgery, Nara Medical UniversityDepartment of Surgery, Nara Medical UniversityDepartment of Surgery, Nara Medical UniversityDepartment of Diagnostic Pathology, Nara Medical UniversityDepartment of Diagnostic Pathology, Nara Medical UniversityDepartment of Plastic Surgery, Nara Medical UniversityDepartment of Surgery, Nara Medical UniversityAbstract Background Anal gland carcinoma with perianal Paget’s disease is rare, and anal gland carcinoma in situ is extremely rare. No cases of anal gland carcinoma in situ with pagetoid spread have been previously reported. Case presentation Physical examination in a 75-year-old woman revealed an erythematous, inflamed, perianal skin lesion. Neither colposcopy, cystoscopy, colonoscopy, computed tomography, nor magnetic resonance imaging showed evidence of malignant genitourinary or gastrointestinal lesions. Histopathological examination of a biopsy specimen showed many Paget’s cells in the perianal skin lesion and no malignant cells in the rectal or vaginal mucosa. Therefore, primary extramammary Paget’s disease of the anogenital region was suspected, and we performed anus-preserving wide local excision. However, immunohistochemistry revealed a diagnosis of secondary extramammary Paget’s disease due to adenocarcinoma arising from the anal gland. We therefore proceeded with a radical operation. Histopathological examination showed no residual cancer cells. The final diagnosis was anal gland adenocarcinoma in situ with pagetoid spread in the perianal skin. Conclusions This is the first case report of anal gland adenocarcinoma in situ with pagetoid spread. We recommend immunohistochemical analysis of biopsy and locally resected specimens to obtain an accurate diagnosis and determine the appropriate treatment when there is no visible tumor.http://link.springer.com/article/10.1186/s40792-018-0469-5Anal gland adenocarcinomaAdenocarcinoma in situPerianal Paget’s disease
spellingShingle Kohei Ishioka
Fumikazu Koyama
Hiroyuki Kuge
Takashi Inoue
Shinsaku Obara
Takayuki Nakamoto
Yoshiyuki Sasaki
Yasuyuki Nakamura
Maiko Takeda
Chiho Ohbayashi
Masamitsu Kuwahara
Masayuki Sho
Anal gland adenocarcinoma in situ with pagetoid spread: a case report
Surgical Case Reports
Anal gland adenocarcinoma
Adenocarcinoma in situ
Perianal Paget’s disease
title Anal gland adenocarcinoma in situ with pagetoid spread: a case report
title_full Anal gland adenocarcinoma in situ with pagetoid spread: a case report
title_fullStr Anal gland adenocarcinoma in situ with pagetoid spread: a case report
title_full_unstemmed Anal gland adenocarcinoma in situ with pagetoid spread: a case report
title_short Anal gland adenocarcinoma in situ with pagetoid spread: a case report
title_sort anal gland adenocarcinoma in situ with pagetoid spread a case report
topic Anal gland adenocarcinoma
Adenocarcinoma in situ
Perianal Paget’s disease
url http://link.springer.com/article/10.1186/s40792-018-0469-5
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