Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014;5(5):234-6.
doi: 10.1016/j.ijscr.2014.02.010. Epub 2014 Mar 12.

Adenocarcinoma arising from an anal gland-Report of a case

Takashi Sakamoto  1 , Fumio Konishi  2 , Takayoshi Yoshida  2 , Yasuo Yoshinaga  3 , Toshiyuki Izumo  4 , Alan Lefor  5
Affiliations

Adenocarcinoma arising from an anal gland-Report of a case

Takashi Sakamoto et al. Int J Surg Case Rep. 2014.

Abstract

Introduction: Adenocarcinoma arising from an anal gland is extremely rare. Most anal canal cancers are squamous cell carcinoma, and adenocarcinoma is infrequently diagnosed. Diagnostic criteria and the standard treatment for adenocarcinoma of the anal canal have not been clearly defined, in part because of the rarity of this lesion.

Presentation of case: An 84-year-old man who presented with a piece of tissue prolapsing from the anus. An incisional biopsy showed adenocarcinoma, and an abdomino-perineal resection was then performed. Cytokeratin 7 (CK7), cytokeratin 19 (CK19) stained positive in the specimen, suggesting that the tumor developed from an anal gland. The patient was discharged after surgery without any complications.

Discussion: Exact diagnostic criteria for adenocarcinoma of the anal canal have not been previously described. In the present case, CK7 and CK19 were stained, and the tumor showed positivity for both of these markers, which is compatible with the staining patterns of anal gland origin cancer. Radical resection is recommended rather than local resection, because of the tumor's high recurrence rate. Some authors recommend combined modality treatment with preoperative or postoperative chemoradiotherapy because of the high rate of distant recurrence.

Conclusion: The preoperative diagnosis of adenocarcinoma arising from an anal gland is not easily established. However, it may be possible to suspect an anal glandular adenocarcinoma based on a meticulous physical examination, appropriate diagnostic studies and pathological findings on biopsy.

Keywords: Adenocarcinoma of an anal gland; Cytokeratin 19; Cytokeratin 7; Immune-histochemical marker; Pagetoid spread.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Endoscopic view of an anal duct with overlying irregular mucosa and angioectasia.
Fig. 2
Fig. 2
Macroscopic findings of the anal canal cancer. The tumor is located in the tissue under the mucosa of the anal canal (arrow).
Fig. 3
Fig. 3
Microscopic findings of the anal canal cancer (hematoxylin and eosin stain). Pagetoid spread.
Fig. 4
Fig. 4
Immunohistochemical stains. (A) Cytokeratin 7 (CK7): diffusely expressed. (B) Cytokeratin 19 (CK19): diffusely expressed.
See this image and copyright information in PMC

References

    1. Whiteford M.H., Stevens K.R., Jr., Oh S., Deveney K.E. The evolving treatment of anal cancer: how are we doing? Arch Surg. 2001;136(August (8)):886–891. - PubMed
    1. Joon D.L., Chao M.W., Ngan S.Y., Joon M.L., Guiney M.J. Primary adenocarcinoma of the anus: a retrospective analysis. Int J Radiat Oncol Biol Phys. 1999;45(December (5)):1199–1205. - PubMed
    1. Fenoglio-Preiser C.M., Noffsinger A.E., Stemmermann G.N., Lantz P.E., Isaacso P.G. Gastrointestinal pathology: an atlas and text. 3rd ed. 2007. Neoplastic lesion of the anus. [Chapter 16]
    1. Leonard D., Beddy D., Dozois E.J. Neoplasms of anal canal and perianal skin. Clin Colon Rectal Surg. 2011;24(March (1)):54–63. - PMC - PubMed
    1. Kuroda N. Anal canal adenocarcinoma with MUC5AC expression suggestive of anal gland origin. Med Mol Morphol. 2007;40(March (1)):50–53. - PubMed