2020 Volume 53 Issue 12 Pages 992-1001
A 57-year-old woman was admitted to our hospital because of erythema on the right side of her anus. A skin biopsy showed Paget cells in the epidermis, and immunohistochemical staining revealed pagetoid spread of anal canal cancer. Although colonoscopy showed no mass lesions in the rectum and step biopsy was negative, mapping biopsy from the anal mucosa was positive. Therefore, we thought it necessary to remove the lesion, including the skin near the anus, to obtain curative resection. There was no evidence of infiltration to the muscularis propria, and we thought that resection in the submucosal layer would ensure a radical cure and preserve anal function. ESD, trans-anal submucosal resection, and cutaneous malignant tumor resection were performed jointly by gastrointestinal surgery, gastroenterology, and dermatology surgeons, respectively. The patient was discharged from hospital 17 days after surgery. In this case of anal canal cancer with pagetoid spread, abdominoperineal rectal resection was avoided and anal function was preserved. We report this relatively rare case including our surgery and the progress of the patient.
