Internal hemorrhoid harboring adenocarcinoma: A case report.

Adenocarcinoma Anal canal Case report Colorectal Hematochezia Hemorrhoidectomy Oncology

Journal

World journal of gastrointestinal oncology
ISSN: 1948-5204
Titre abrégé: World J Gastrointest Oncol
Pays: China
ID NLM: 101532470

Informations de publication

Date de publication:
15 Jan 2021
Historique:
received: 16 06 2020
revised: 01 09 2020
accepted: 11 10 2020
entrez: 29 1 2021
pubmed: 30 1 2021
medline: 30 1 2021
Statut: ppublish

Résumé

The incidence of carcinoma found within an internal hemorrhoid specimen is exceptionally rare. Further, the presence of primary anal canal adenocarcinoma within internal hemorrhoids is even more infrequent. We describe a case in which anal canal adenocarcinoma was found within an internal hemorrhoidectomy specimen and perform a review of the current literature. The patient was a 79-year-old male who presented with rectal bleeding and was found to have large thrombosed internal hemorrhoids during screening colonoscopy. The patient subsequently underwent a three-column hemorrhoi-dectomy. Pathologic analysis revealed one of three specimens containing a 1.5 cm moderate-to-poorly differentiated adenocarcinoma of anal origin with superficial submucosal invasion. At three-month follow up, he was taken to the operating theatre for biopsy and re-excision of his non-healing wound, which showed no recurrence. His wound has since healed and he was cancer free at ten-month follow up. When faced with primary anal canal adenocarcinoma an interdisciplinary approach to treatment should be considered. Routine pathological analysis of hemorrhoidectomy specimens may be beneficial due to the severity of anal canal carcinomas if left undiagnosed and untreated in a timely manner.

Sections du résumé

BACKGROUND BACKGROUND
The incidence of carcinoma found within an internal hemorrhoid specimen is exceptionally rare. Further, the presence of primary anal canal adenocarcinoma within internal hemorrhoids is even more infrequent. We describe a case in which anal canal adenocarcinoma was found within an internal hemorrhoidectomy specimen and perform a review of the current literature.
CASE SUMMARY METHODS
The patient was a 79-year-old male who presented with rectal bleeding and was found to have large thrombosed internal hemorrhoids during screening colonoscopy. The patient subsequently underwent a three-column hemorrhoi-dectomy. Pathologic analysis revealed one of three specimens containing a 1.5 cm moderate-to-poorly differentiated adenocarcinoma of anal origin with superficial submucosal invasion. At three-month follow up, he was taken to the operating theatre for biopsy and re-excision of his non-healing wound, which showed no recurrence. His wound has since healed and he was cancer free at ten-month follow up.
CONCLUSION CONCLUSIONS
When faced with primary anal canal adenocarcinoma an interdisciplinary approach to treatment should be considered. Routine pathological analysis of hemorrhoidectomy specimens may be beneficial due to the severity of anal canal carcinomas if left undiagnosed and untreated in a timely manner.

Identifiants

pubmed: 33510851
doi: 10.4251/wjgo.v13.i1.87
pmc: PMC7805272
doi:

Types de publication

Case Reports

Langues

eng

Pagination

87-91

Informations de copyright

©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.

Déclaration de conflit d'intérêts

Conflict-of-interest statement: The authors have no conflicts of interest and nothing to disclose.

Références

Surg Gynecol Obstet. 1992 Apr;174(4):302-4
pubmed: 1553609
Am Surg. 2000 Aug;66(8):789-92
pubmed: 10966042
World J Surg. 2009 Oct;33(10):2189-93
pubmed: 19669232
N Engl J Med. 1997 Nov 6;337(19):1350-8
pubmed: 9358129
J Natl Cancer Inst. 1989 Nov 15;81(22):1726-31
pubmed: 2810388
J Heart Lung Transplant. 1993 Nov-Dec;12(6 Pt 2):S328-36
pubmed: 8312352
Am Surg. 2001 Nov;67(11):1048-58
pubmed: 11730221
Radiographics. 2015 Nov-Dec;35(7):2090-107
pubmed: 26562239
J Med Case Rep. 2008 Apr 28;2:128
pubmed: 18442399
Int J Colorectal Dis. 2007 Nov;22(11):1407-1408
pubmed: 16804669

Auteurs

Michael L Caparelli (ML)

Department of Surgery, The Jewish Hospital, Cincinnati, OH 45236, United States.

Jason C Batey (JC)

Department of Surgery, The Jewish Hospital, Cincinnati, OH 45236, United States.

Anisha Tailor (A)

Department of Surgery, The Jewish Hospital, Cincinnati, OH 45236, United States.

Timothy Braverman (T)

Department of Pathology, The Jewish Hospital, Cincinnati, OH 45236, United States.

Cory Barrat (C)

Department of Surgery, The Jewish Hospital, Cincinnati, OH 45236, United States. jbatey@mercy.com.

Classifications MeSH