Other anal malignancies

Other anal malignancies

Adenocarcinoma within the anal canal is usually an extension of a distal rectal cancer. Rarely , adenocarcinoma may arise from anal glandular epithelium or develop within a longstand - ing (usually complex) anal fistula, hence the need to biopsy non-healing fi stula- in - ano . The treatment is as for low rectal cancers (i.e. abdominoperineal excision of the rectum with or without neoadjuvant chemoradiotherapy , Chapter 79 ). Malignant melanoma of the anus is very rare and usually pres - ). ents as a bluish-black soft mass that may mimic a thrombosed external pile, although it may be amelanotic. The prognosis, irrespective of treatment, is extremely poor. Perianal Paget’ s disease is exceedingly rare. - Summary box 80.13 Anal cancer /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF

Uncommon, usually squamous cell Associated with HPV, HIV and immunosuppression Lymphatic spread is to the inguinal lymph nodes Treatment is by chemoradiotherapy in the /f_i rst instance Major ablative surgery is required for salvage

Figure 80.41 Y–V advancement /f_l ap for anal stenosis.