Abstract
We report a rare case of a mucinous carcinoma with pagetoid spread in the anal gland. The case is a 79-year-old male presenting with anal pain. Physical examination revealed a perianal mass located from the lower part of the rectum to the anal canal. Colonoscopy confirmed a lesion located in the lower part of rectum, but we could not identify any malignant cells on the mucous membrane biopsy. Ultrasound examination showed a heterogeneous low echoic mass with unclear indistinct borders. Echography-guided biopsy indicated the diagnosis was mucinous cancer. We performed abdominoperineal resection. Histopathological inspection of the resected specimen showed that the mucinous cancer cells were located under the anal squamous epithelium, with pagetoid spread in the anal squamous epithelium. Based on the findings, we diagnosed the case as mucinous adenocarcinoma of the anal gland. Adenocarcinoma of the anal gland involves a lesion in the wall of the anal canal, and it is a rare finding that the cancer is not exposed to the mucous membrane. A literature review is included.
