항문관 암종

초록

Anal duct carcinoma, also known as anal gland carcinoma or adenocarcinoma of the anal canal, is an unusual ana cancer that accounts for approximately 0.1% of all gastrointestinal cancers. The tissues of origination are the glands of the anal duct. The features that differentiated this tumor from the usual rectal adenocarcinoma are proximent ductal structures, abundant mucin production with organized mucinous pools, and infiltration into the perirectal soft tissue. Delays in diagnosis most likely account for the poor prognosis associated with this cancer. Oresenting symptoms often mimic those of more common benign anorectal pathologic processes. The clinical management of anal duct carcinoma remains surgical challenge. The extent of surgical resection must be radical because of the infiltrative nature of the tumor. Multimodality treatment that includes surgery, chemotherapy, and radication terapy is aften recommended. We experienced a case of anal duct carcinoma, clinically presented as buttock lesion. The patient was a 62 year old male sho had a past history of a hemorrhoid for the past 40years and anal fistula for 10 years. He tool fistulectomy operation two times. one year ago, pain, redness, and heating sensation were developed in both bottock area. At that time, CT scan revealed multiple abscess in perirectal, perianal, retrovesical and subcutaneous fat of both bottocks with fluid collection. Multiple enlargement of lymph nodes were present in internal and external iliac chain. He underwent an incision and drainage and colostomy of transverse colon. Althought antibiotics therapy, the lesion did not subside and the MRI revealed multiseptated cystic lesions involving pelvic cavity, perineum and presacral space. Incision and darainage were performed, again. Histologically, the lesion was composed of a low grade mucinous tumor that forms large amount of colloid, suppurative exudate, and granulation tissue.