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Small cell carcinoma of the anus: a case report.

Doddi S, Singhal T, De Silva C, Smedley F, Sinha P, Leslie M - Cases J (2009)

Bottom Line: She had no metastatic disease on presentation.Immunohistochemistry is required to make a diagnosis.Chemotherapy remains the mainstay of treatment for small cell carcinoma of the anus with or without metastatic disease.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, Princess Royal University Hospital, Orpington, Greater London, BR6 8ND, UK.

ABSTRACT
Small cell carcinoma of the anus is a very rare but aggressive tumour. We present a case of a 60-year old lady with small cell carcinoma of the anus. She had no metastatic disease on presentation. She had chemotherapy and radiotherapy but developed distant metastasis after completion of treatment. Immunohistochemistry is required to make a diagnosis. Chemotherapy remains the mainstay of treatment for small cell carcinoma of the anus with or without metastatic disease. Radiotherapy is for local control and relief of symptoms.

No MeSH data available.


Related in: MedlinePlus

Haematoxylin and eosin staining of the small cell carcinoma of the anus.
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Figure 2: Haematoxylin and eosin staining of the small cell carcinoma of the anus.

Mentions: A 60-year old African lady originally from Ghana presented with a short history of rectal bleeding and anal pain. Over the past three months, she had noticed tenesmus and increased frequency of bowel movements, as well as anorexia and weight loss. There was no significant past or family history. She was a non-smoker. On rectal examination there was a palpable mass which bled on contact. There were no clinical features of bowel obstruction. An MRI of the anus showed a 2.7 cm tumour in the posterior aspect of the distal anal canal (Figure 1). At examination under anaesthetic (EUA) the mass in the anus was confirmed and biopsies were taken. The histopathology showed small malignant cells with hyperchromatic nuclei and scanty cytoplasm on haematoxylin and eosin staining (Figure 2). On immunostaining, the malignant cells were strongly positive for CD56 (Figure 3) and showed weak focal positivity for CAM 5.2 and MNF. There was negative staining for CK7, CK20, thyroid transcription factor 1 (TTF-1) and leukocyte common antigen. These results were consistent with a primary small cell carcinoma of the anus. The patient was not tested for HIV and tumour markers were not measured. Staging CT and PET scans showed no evidence of metastatic disease. The patient underwent treatment with six cycles of chemotherapy using cisplatinum and etoposide followed by a course of radical radiotherapy to the anus and pelvis. Following treatment there was thickening at the primary tumour site; however two EUA's and biopsies did not show any residual tumour. Twelve months after completion of treatment the patient relapsed with liver and lung metastasis although the primary site remained clear. No response was seen to palliative chemotherapy and the patient succumbed to metastatic disease 18 months following the initial diagnosis.


Small cell carcinoma of the anus: a case report.

Doddi S, Singhal T, De Silva C, Smedley F, Sinha P, Leslie M - Cases J (2009)

Haematoxylin and eosin staining of the small cell carcinoma of the anus.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2806881&req=5

Figure 2: Haematoxylin and eosin staining of the small cell carcinoma of the anus.
Mentions: A 60-year old African lady originally from Ghana presented with a short history of rectal bleeding and anal pain. Over the past three months, she had noticed tenesmus and increased frequency of bowel movements, as well as anorexia and weight loss. There was no significant past or family history. She was a non-smoker. On rectal examination there was a palpable mass which bled on contact. There were no clinical features of bowel obstruction. An MRI of the anus showed a 2.7 cm tumour in the posterior aspect of the distal anal canal (Figure 1). At examination under anaesthetic (EUA) the mass in the anus was confirmed and biopsies were taken. The histopathology showed small malignant cells with hyperchromatic nuclei and scanty cytoplasm on haematoxylin and eosin staining (Figure 2). On immunostaining, the malignant cells were strongly positive for CD56 (Figure 3) and showed weak focal positivity for CAM 5.2 and MNF. There was negative staining for CK7, CK20, thyroid transcription factor 1 (TTF-1) and leukocyte common antigen. These results were consistent with a primary small cell carcinoma of the anus. The patient was not tested for HIV and tumour markers were not measured. Staging CT and PET scans showed no evidence of metastatic disease. The patient underwent treatment with six cycles of chemotherapy using cisplatinum and etoposide followed by a course of radical radiotherapy to the anus and pelvis. Following treatment there was thickening at the primary tumour site; however two EUA's and biopsies did not show any residual tumour. Twelve months after completion of treatment the patient relapsed with liver and lung metastasis although the primary site remained clear. No response was seen to palliative chemotherapy and the patient succumbed to metastatic disease 18 months following the initial diagnosis.

Bottom Line: She had no metastatic disease on presentation.Immunohistochemistry is required to make a diagnosis.Chemotherapy remains the mainstay of treatment for small cell carcinoma of the anus with or without metastatic disease.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, Princess Royal University Hospital, Orpington, Greater London, BR6 8ND, UK.

ABSTRACT
Small cell carcinoma of the anus is a very rare but aggressive tumour. We present a case of a 60-year old lady with small cell carcinoma of the anus. She had no metastatic disease on presentation. She had chemotherapy and radiotherapy but developed distant metastasis after completion of treatment. Immunohistochemistry is required to make a diagnosis. Chemotherapy remains the mainstay of treatment for small cell carcinoma of the anus with or without metastatic disease. Radiotherapy is for local control and relief of symptoms.

No MeSH data available.


Related in: MedlinePlus