Abstract
A 50-year-old woman was transferred to our hospital for the definite diagnosis and treatment of a tumor at the perianal region. Her previous proctologist's biopsy revealed a squamous cell carcinoma (SCC) at the region. Repeated biopsy and imaging including PET/CT, CT, and MRI determined the final diagnosis of perianal SCC at Stage Ⅳ with T3N2M1. HPV-16 was also detected by PCR and direct sequencing from a biopsy specimen. Since the tumor had invaded the inside of the anal canal, concurrent chemoradiotherapy with 5-FU/MMC was performed following NCCN guidelines for the standard treatment of an anal canal SCC. The treatment was successful in attaining complete remission, which was confirmed by close imaging examinations and repeated biopsy. After 1 year and 6 months from the treatment, no recurrence has been observed, with well-preserved anal functions and good QOL. SCC, if therapeutically intervened at an early stage, shows relatively good prognosis with little difficulty in choosing an appropriate treatment. However, if in a progressive stage, it is very difficult to treat it, as is also true for other types of cancer. Radical excision, even if it is indicated to be a definite treatment for a surgically treatable case, may result in functional disabilities and aesthetic loss depending upon the site of operation. We always come up against a dilemma as to whether radical treatment of a cancer may have too much adverse impact on a patient's QOL. We reported the present case because it was considered that concurrent chemoradiotherapy might be a preferable choice for a radical treatment of a perianal SCC, especially those juxtaposing to the denticulate line of the anus.
