Endoscopic submucosal dissection (ESD) for anal high-grade intraepithelial neoplasia: a case report

Abstract

Anal intraepithelial neoplasia (AIN) is a precursor of anal carcinoma. Conventional therapy is based on topical and local ablative approaches. However, the recurrence rates are very high, leading to repetitive treatment sessions and need for long-term surveillance. Endoscopic submucosal dissection (ESD) is an established treatment for malignant early neoplasias of the gastrointestinal tract, especially in the esophagus, stomach, and colorectum. Japanese centers have reported few cases of ESD for early anal carcinoma. We report a case of high-grade AIN diagnosed with magnifying narrow-band imaging and chromoendoscopy that was resected R0 with ESD en bloc.

Zusammenfassung

Die anale intraepitheliale Neoplasie (AIN) ist die Vorläuferläsion des Analkarzinoms. Bisherige Therapieoptionen beschränkten sich auf topische und ablative Verfahren, denen eine sehr hohe Rezidivrate gemeinsam ist. Dies macht engmaschige Verlaufsuntersuchungen und Nachbehandlungen erforderlich. Die Endoskopische Submukosadissektion (ESD) hat sich als Therapie von malignitätsverdächtigen Frühneoplasien des Gastrointestinaltraktes im Ösophagus, Magen und Kolon etabliert. Zur ESD von analen Frühkarzinomen liegen nur einzelne Fallberichte aus japanischen Zentren vor. Der vorliegende Fallbericht stellt die R0 Resektion einer hochgradigen AIN mittels en-bloc ESD nach umfassender Diagnostik mit hochauflösender Videoendoskopie vor.

Schlüsselwörter

Endoskopische Submukosadissektion - anale intraepitheliale Neoplasie - Resektion

Key words

endoscopic submucosal dissection - anal intraepithelial neoplasia - resection

• References

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