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Clin Colon Rectal Surg 2002; 15(4): 277-284
DOI: 10.1055/s-2002-36510
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Anal Margin Lesions

David E. Beck, Alan E. Timmcke
  • Department of Colon and Rectal Surgery, Ochsner Clinic Foundation, New Orleans, Louisiana
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Publication History

Publication Date:
07 January 2003 (online)

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ABSTRACT

Malignant and potentially malignant lesions of the anal margin are rare. A knowledge of anal margin anatomy aids in understanding pathology and treatment; however, additional standardization of terminology is needed. Wide local excision appears to be adequate treatment for most of these lesions. A few very large or extensive lesions may benefit from combination therapy or radical surgery.

KEYWORD

Bowen's disease - Paget's disease - Bowenoid papulosis - high-grade squamous intraepithelial lesions - anal intraepithelial neoplasias - leukoplakia - squamous cell cancer - basal cell cancer - verrucous carcinoma - Kaposi's sarcoma

REFERENCES

  • 1 Billingham R. Neoplasms of the anus and the perianal skin. In: Mazier WP, Levien DH, Luchtefeld MA, Senagore AJ, eds. Surgery of the Colon, Rectum, and Anus Philadelphia, PA: WB Saunders 1995: 205-228
    Google Scholar
  • 2 Beck D E, Wexner S D. Anal neoplasms. In: Beck DE, Wexner SD, eds. Fundamentals of Anorectal Surgery New York: McGraw-Hill 1992: 222-237
    Google Scholar
  • 3 Beck D E. Malignancies of the colon, rectum and anus. In: Beck DE, ed. Handbook of Colon and Rectal Surgery St. Louis, MO: Quality Medical Publishing 1997: 421-430
    Google Scholar
  • 4 Gordon P H. Current status-perianal and anal canal neoplasms.  Dis Colon Rectum . 1990;  33 799-808
    CrossrefPubMedGoogle Scholar
  • 5 Nivatvongs S. Perianal and anal canal neoplasms. In: Gordon PH, Nivatvongs S, eds. Principles and Practice of Surgery for the Colon, Rectum, and Anus, 2nd ed St. Louis, MO: Quality Medical Publishing 1999: 447-471
    Google Scholar
  • 6 Papillon J, Chassard J L. Respective roles of radiotherapy and surgery in the management of epidermoid carcinoma of the anal margin.  Dis Colon Rectum . 1992;  35 422-429
    PubMedGoogle Scholar
  • 7 Beahrs O H, Wilson S M. Carcinoma of the anus.  Ann Surg . 1976;  184 422-428
    PubMedGoogle Scholar
  • 8 Jensen S L, Hagen K, Shokouh-Amiri M H, Nielsen O V. Does an erroneous diagnosis of squamous-cell carcinoma of the anal canal and margin at first physician visit influence prognosis?.  Dis Colon Rectum . 1987;  30 345-351
    PubMedGoogle Scholar
  • 9 Localio S A, Eng K, Coppa G F. Anorectal presacral and sacral tumors.  Philadelphia, PA: WB Saunders 1987: 46-67
    Google Scholar
  • 10 Schraut W H, Wang C, Dawson P J, Block G E. Depth of invasion, location, and size of cancer of the anus dictate operative treatment.  Cancer . 1983;  51 1291-1296
    CrossrefPubMedGoogle Scholar
  • 11 Cummings B J, Keane T J, Hawkins N V, O'Sullivan B. Treatment of perianal carcinoma by radiation (RT) or radiation plus chemotherapy (RTCT).  Int J Radiat Oncol Biol Phys . 1986;  12 170-173
    PubMedGoogle Scholar
  • 12 Mendenhall W H, Zlotecki R A, Vauthey J, Copeland E M. Squamous cell carcinoma of the anal margin.  Oncology . 1996;  10 1843-1848
    PubMedGoogle Scholar
  • 13 Touboul E, Schlienger M, Buffat L. Epidermoid carcinoma of the anal margin: 17 cases treated with curative intent radiation therapy.  Radiother Oncol . 1995;  34 195-202
    CrossrefPubMedGoogle Scholar
  • 14 Corman M L. Less common tumors and tumor-like lesions of the colon, rectum, and anus. In: Corman ML, ed. Colon and Rectal Surgery, 2nd ed Philadelphia, PA: Lippincott 1989: 579-596
    Google Scholar
  • 15 Nielson O V, Jensen S L. Basal cell carcinoma of the anus: a clinical study of 34 cases.  Br J Surg . 1981;  68 856-857
    PubMedGoogle Scholar
  • 16 Armitage G, Smith I. Rodent ulcer of the anus.  Br J Surg . 1954;  42 395-398
    PubMedGoogle Scholar
  • 17 Cintrom J R. Buschke-Lowenstein tumor of the perianal and anorectal region.  Semin Colon Rectal Surg . 1995;  6 135-139
    PubMedGoogle Scholar
  • 18 Gold J A, Nurnberger F G. A tribute to Abraham Buschke.  J Am Acad Dermatol . 1992;  26 1019-1022
    CrossrefPubMedGoogle Scholar
  • 19 Buschke A. Neisser's Sterokopischer Atlas.  New York: Fisher 1896
    Google Scholar
  • 20 Buschke A, Loewenstein L. Carcinomahnliche condylomata despenis.  Klin Wochenschr . 1925;  4 1726-1728
    CrossrefPubMedGoogle Scholar
  • 21 Dawson D F, Duckworth J K, Bernhardt H, Young J M. Giant condyloma and verrucous carcinoma of the genital area.  Arch Pathol . 1965;  79 2225-2231
    PubMedGoogle Scholar
  • 22 Chu Q D, Vezeridis M P, Libbey N P. Giant condylomata acuminatum (Buschke-Loewenstein tumor) of the anorectal and perineal regions.  Dis Colon Rectum . 1994;  37 950-957
    CrossrefPubMedGoogle Scholar
  • 23 Creasman C, Haas P A, Fox T A. Malignant transformation of anorectal giant condylomata acuminatum (Buschke-Lowenstein tumor).  Dis Colon Rectum . 1989;  32 481-487
    PubMedGoogle Scholar
  • 24 Kaufman T, Nisce L Z, Coleman M. Case report: Kaposi's sarcoma of the rectum-treatment with radiation therapy.  Br J Radiol . 1996;  69 573-574
    PubMedGoogle Scholar
  • 25 Margolin D A, Beck D E, Wexner S D. Acquired immunodeficiency syndrome. In: Beck DE, Wexner SD, eds. Fundamentals of Anorectal Surgery, 2nd ed London: WB Saunders 1998: 432-450
    Google Scholar
  • 26 Kirova Y M, Belembaogo E, Frikha H. Radiotherapy in the management of epidemic Kaposi's sarcoma: a retrospective study of 643 cases.  Radiother Oncol . 1998;  46 19-22
    CrossrefPubMedGoogle Scholar
  • 27 Paget J. On disease of the mammary areola preceding cancer of the mammary gland.  Saint Bartholomew's Hospital Report . 1874;  10 87-89
    PubMedGoogle Scholar
  • 28 Darier J, Coulillaud P. Sur un case maladie de Paget de la region perineo-anal et scrotale.  Ann Dermatol Syphiligr . 1893;  4 33
    PubMedGoogle Scholar
  • 29 Beck D E, Fazio V W. Premalignant lesions of the anal margin.  South Med J . 1989;  82 470-474
    PubMedGoogle Scholar
  • 30 Beck D E, Fazio V W. Perianal Paget's disease.  Dis Colon Rectum . 1987;  30 263-266
    CrossrefPubMedGoogle Scholar
  • 31 Jensen S L, Sjolin K E, Shokouh-Amiri M H, Hagen K, Harling H. Paget's disease of the anal margin.  Br J Surg . 1988;  75 1089-1092
    PubMedGoogle Scholar
  • 32 Armitage N C, Jass J R, Richman P I, Thomson J PS, Phillips R KS. Paget's disease of the anus: a clinicopathologic study.  Br J Surg . 1989;  76 60-63
    PubMedGoogle Scholar
  • 33 Helwig E B, Graham J H. Anogenital (extramammary) Paget's disease: a clinopathological study.  Cancer . 1963;  16 387-403
    PubMedGoogle Scholar
  • 34 Gross G, Ikenberg H, Grosshans E. Bowenoid papulosis. Presence of human papillomavirus (HPV) structural antigens and of HPV-16 related DNA sequences.  Arch Dermatol . 1985;  121 858-863
    CrossrefPubMedGoogle Scholar
  • 35 Wade T R, Kopf A W, Ackerman B. Bowenoid papulosis of the genitalia.  Arch Dermatol . 1979;  115 306-308
    CrossrefPubMedGoogle Scholar
  • 36 Bowen J T. Precancerous dermatoses: a study of 2 cases of chronic atypical epithelial proliferation.  J Cutan Dis . 1912;  30 241-255
    PubMedGoogle Scholar
  • 37 Vickers P M, Jackman R J, McDonald J R. Anal carcinoma in situ: report of three cases.  South Surg . 1939;  8 503-507
    PubMedGoogle Scholar
  • 38 Beck D E. Paget's disease and Bowen's disease of the anus.  Sem Colon Rectal Surg . 1995;  6 143-149
    PubMedGoogle Scholar
  • 39 Beck D E, Fazio V W, Jagelman D G, Lavery I C. Perianal Bowen's disease.  Dis Colon Rectum . 1989;  32 252-255
    PubMedGoogle Scholar
  • 40 Graham J H, Helwig E B. Bowen's disease and its relationship to systemic cancer.  Arch Dermatol . 1961;  88 738-751
    PubMedGoogle Scholar
  • 41 Arbesman H, Ransohoff D F. Is Bowen's disease a predictor for the development of internal malignancy?.  <~>A methodological critique of the literature. JAMA . 1987;  257 516-518
    PubMedGoogle Scholar
  • 42 Marfig T E, Abel M E, Galligher D M. Perianal Bowen's disease and associated malignancies: results of a survey.  Dis Colon Rectum . 1987;  30 782-785
    PubMedGoogle Scholar
  • 43 Ikenberg H, Gissmann L, Gross G. Human papillomavirus type-16-related DNA in genital Bowen's disease and in Bowenoid papulosis.  Int J Cancer . 1983;  32 563-565
    PubMedGoogle Scholar
  • 44 Wexner S D, Milson J W, Dailey T M. The demographics of anal cancers are changing: identification of a high-risk population.  Dis Colon Rectum . 1987;  30 942-946
    PubMedGoogle Scholar
  • 45 Gross G, Roussaki A, Schopf E. Successful treatment of condylomata acuminata and Bowenoid papulosis with subcutaneous injections of low-dose recombinant interferon-alpha.  Arch Dermatol . 1986;  122 749-750
    CrossrefPubMedGoogle Scholar
  • 46 Kotlarewsky M, Freeman J B, Cameron W, Grimard L J. Anal intraepithelial dysplasia and squamous carcinoma in immunosuppressed patients.  Can J Surg . 2001;  44 450-454
    PubMedGoogle Scholar
  • 47 Chang G J, Berry J M, Palefsky J M, Welton M L. Surgical treatment of high-grade anal squamous intraepithelial lesions: a prospective study.  Dis Colon Rectum . 2002;  45 453-458
    CrossrefPubMedGoogle Scholar
  • 48 Zbar A P, Fenger C, Efron J, Beer-Gabel M, Wexner S D. The pathology and molecular biology of anal intraepithelial neoplasia: comparisons with cervical and vulvar intraepithelial carcinoma.  Int J Colorectal Dis . 2002;  17 203-215
    CrossrefPubMedGoogle Scholar
  • 49 Corman M L. Premalignant and malignant dermatoses.  Colon and Rectal Surgery. Philadelphia, PA: Lippincott 1989: 421-422
    Google Scholar
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