Metachronous tubulovillous and tubular adenomas of the anal canal.
Metachronous tubulovillous and tubular adenomas of the anal canal.
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DOI：
10.1186/s13000-015-0379-9
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发表时间：
2015-08-07
影响因子：
2.6
通讯作者：
Watanabe T
中科院分区：
文献类型：
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作者：
Nozawa H;Ishihara S;Morikawa T;Tanaka J;Yasuda K;Ohtani K;Nishikawa T;Tanaka T;Kiyomatsu T;Kawai K;Hata K;Kazama S;Yamaguchi H;Sunami E;Kitayama J;Fukayama M;Watanabe T
肛管腺瘤是一种非常罕见的疾病，有可能转化为恶性肿瘤。我们在此报告一位罕见的肛管多发性异时性腺瘤病例。一名48岁的女性在粪便血检阳性后接受了全结肠镜检查。一个9毫米长的绒毛状息肉从肛管后壁产生的圈套息肉切除术。组织学上，肿瘤为管状绒毛状腺瘤伴高度异型增生，切端肿瘤细胞阴性。六年后，在一次随访结肠镜检查中，在肛管左壁发现了一个肉眼可见的5毫米大小的隆起病变。进行肿瘤局部切除，病理证实病变为管状腺瘤伴局限于粘膜的高度异型增生。该患者目前还活着，手术后六个月没有任何复发的证据。虽然她有宫颈癌病史，但肛管多发性肿瘤不太可能与人乳头瘤病毒感染有关。我们的病例报告强调了在整个结肠镜检查过程中仔细观察的重要性，以发现癌前病变，特别是在解剖学狭窄段。
Anal canal adenoma is an extremely rare disease that has the potential to transform into a malignant tumor. We herein presented a rare case of metachronous multiple adenomas of the anal canal. A 48-year-old woman underwent total colonoscopy following a positive fecal blood test. A 9-mm villous polyp arising from the posterior wall of the anal canal was removed by snare polypectomy. Histologically, the tumor was tubulovillous adenoma with high-grade dysplasia and the cut end was negative for tumor cells. Six years later, an elevated lesion, macroscopically five millimeters in size, was detected in the left wall of the anal canal in a follow-up colonoscopy. Local excision of the tumor was performed, and the lesion was pathologically confirmed to be tubular adenoma with high-grade dysplasia limited to the mucosa. The patient is currently alive without any evidence of recurrence for six months after surgery. Although she had a past history of cervical cancer, the multiple tumors arising in the anal canal were unlikely to be related to human papilloma virus infection. Our case report underscores the importance of careful observations throughout colonoscopy to detect precancerous lesions, particularly in anatomically narrow segments.