Anal Gland Carcinoma Research Articles

HISTOPATHOLOGICAL STUDY OF LESIONS OF ANAL CANAL

Background. Diverse diseases including congenital anomalies like Hirschsprung disease, anorectal agenesis, infections like tuberculosis, parasitic infestations, inammatory disorders like Crohn's disease ulcerative colitis, and neoplasms like adenomas, adenocarcinomas, squamous cell carcinoma etc, involve the anal canal. Despite its short length, the anal canal produces a variety of tumor types reecting its complex anatomic and histologic features (WHO). Majority of these disorders present with common symptoms like constipation, per rectal bleeding, altered bowel habits and difculty in defecation. The study was undertaken with the aim of a Aim: nalysing the histopathological lesions of anal canal with clinicopathological corelation. Total 116 lesions affecting anal canal over Materials and methods: a period of January 2013 to June 2017(4.5 years) were included in this study. Demographics of patients, presenting symptoms and pathologic features were recorded. Out of 116 Results: lesions, 106 were nonneoplastic, greatly outnumbering the eight neoplastic lesions. Anal stula was the most common lesion accounting for 49 cases. Most common age group affected was 31-40 years. Conclusion: Histopathological examination of every anal lesion is important since clinical presentation of neoplastic and nonneoplastic disorder is same. Rare entities like anal gland carcinoma can be diagnosed only on histopathology

Radiation therapy for the treatment of macroscopic canine anal gland tumors - a retrospective study

Canine anal gland tumors are locally invasive and early metastasize to the loco-regional pelvic lymph nodes. Radiation therapy is a good method for loco-regional tumor control, especially in inoperable tumors. Since the organs in the pelvic area are sensitive to both acute and late radiation damage (chronic diarrhea, bleeding, strictures or intestinal perforations) and such damage mainly depends on the fraction size, we examined the radiation protocol used in this study with a reduced number of fractions (hypofractionated) regarding effectiveness and side effects. This retrospective study describes 13 dogs with macroscopic anal gland carcinoma that were irradiated with imaging-guided, intensity-modulated radiation therapy with a hypofractionated curative protocol of 12 × 3,8 Gy. Gross pathology was either in the region of the anal gland and/or in the sublumbar lymph nodes. Ten of the 13 dogs had advanced tumor diseases (stage 3a or 3b). The acute radiation reactions were mild to moderate and had been reported for some of the dogs in a previous study. The mean study time was 572 days (range 105-1292 days). Disease progression was observed or suspected in 7/13 dogs during the study period: local or loco-regional progression occurred in 3 dogs (23 %) and distant metastases in 4 dogs (31 %). Median progression-free survival was 480 days (95 %CI, 223-908), median survival was 597 days (95 %CI, 401-908). One year after treatment, 76,9 % (95 %CI, 53,5-100) of the dogs were still alive. The likelihood of tumor progression was lower with increasing age, otherwise none of the examined tumor or patient factors showed a prognostic influence on progression or survival time. No clinically relevant late side effects were observed apart from slight alopecia, pigmentation changes or dry, scaly skin, Medium to long-term tumor control can be expected in dogs with macroscopic anal gland tumors treated with a moderately hypofractionated radiation therapy protocol (12 × 3,8 Gy). During long-term monitoring no serious side effects or side effects requiring treatment were observed.

Early anal gland adenocarcinoma with a characteristic submucosal tumor-like appearance: a case report

BackgroundThe clinical findings of early anal gland carcinoma (AGC) have not been well delineated because AGC is a rare malignancy usually diagnosed at an advanced stage. Knowledge of the characteristic findings will be helpful for both diagnosis and determination of the treatment options for early AGC.Case presentationA 62-year-old man was referred to our hospital for treatment of a rectal submucosal tumor (SMT) detected during a medical checkup at another hospital. Trans-sacral resection of the tumor was performed under the diagnosis of a rectal benign cyst. Pathological examination of the resected tumor showed a mucin-producing adenoma. About 14 months later, a new cystic lesion was found by follow-up examination, and trans-sacral resection of the tumor was performed again. The second pathological diagnosis was a mucinous adenocarcinoma with a possible remnant tumor at the local site. After providing sufficient informed consent, the patient underwent intersphincteric resection (ISR) of the rectum to preserve anal function. The final diagnosis was mucinous adenocarcinoma of the anal gland, T1N0M0. The patient remained alive without recurrence or complications for 6 years 7 months postoperatively.ConclusionWe have herein reported a case of early AGC with a characteristic SMT-like appearance. Because the anal gland is located within both the submucosal layer and the internal sphincter muscle, ISR may be selected when the tumor is limited to inside the gland.

Anal gland adenocarcinoma in situ with pagetoid spread: a case report

BackgroundAnal gland carcinoma with perianal Paget’s disease is rare, and anal gland carcinoma in situ is extremely rare. No cases of anal gland carcinoma in situ with pagetoid spread have been previously reported.Case presentationPhysical examination in a 75-year-old woman revealed an erythematous, inflamed, perianal skin lesion. Neither colposcopy, cystoscopy, colonoscopy, computed tomography, nor magnetic resonance imaging showed evidence of malignant genitourinary or gastrointestinal lesions. Histopathological examination of a biopsy specimen showed many Paget’s cells in the perianal skin lesion and no malignant cells in the rectal or vaginal mucosa. Therefore, primary extramammary Paget’s disease of the anogenital region was suspected, and we performed anus-preserving wide local excision. However, immunohistochemistry revealed a diagnosis of secondary extramammary Paget’s disease due to adenocarcinoma arising from the anal gland. We therefore proceeded with a radical operation. Histopathological examination showed no residual cancer cells. The final diagnosis was anal gland adenocarcinoma in situ with pagetoid spread in the perianal skin.ConclusionsThis is the first case report of anal gland adenocarcinoma in situ with pagetoid spread. We recommend immunohistochemical analysis of biopsy and locally resected specimens to obtain an accurate diagnosis and determine the appropriate treatment when there is no visible tumor.

Temporally separated bilateral anal sac gland carcinomas in four dogs

Anal sac gland carcinoma arising from the apocrine secretory epithelium in the anal sac wall, is locally invasive and highly metastatic. The majority of anal sac gland carcinomas are unilateral on presentation, but bilateral tumours have been identified. This case series presents the outcome of four unique cases of unilateral anal sac gland carcinoma which subsequently developed contralateral anal sac gland carcinoma 50 to 390 days after removal of the initial tumour. Median survival was 1035 days after initial diagnosis and 807 days after diagnosis of the second anal sac gland carcinoma.

Association between anal sac gland carcinoma and dog leukocyte antigen-DQB1 in the English Cocker Spaniel

Anal sac gland carcinomas occur frequently in English Cocker Spaniels and, to a lesser extent, in other spaniel breeds. The disease typically presents in dogs aged 8 years or older and frequently metastasises to the local lymph nodes. The association between anal sac gland carcinoma in English Cocker Spaniels and the major histocompatibility complex class II loci (the dog leukocyte antigen loci DLA-DRB1, -DQA1, -DQB1) was investigated in 42 cases and 75 controls. Based on a corrected error rate of 0.017 for each test, the allele distribution in DLA-DRB1 showed no significant difference between cases and controls (P value = 0.019), while a significant difference was obtained for DLA-DQA1 and -DQB1 alleles (P values are 0.010 and 3.3 × 10⁻⁵). The DLA-DQB1*00701 allele was the most common in both cases and controls, but it had a higher frequency among the former (0.89) than in the latter (0.61), while the second most common allele had a higher frequency in the controls (0.23) than in the cases (0.07). Haplotype distributions were also significantly different between the two groups (P value = 1.61 × 10⁻⁴). This is the second disease in English Cocker Spaniels for which the most common DLA-DQB1 allele in the breed has been shown to have a higher frequency in cases than controls, while the second most common allele in the breed (*02001) has a significantly higher frequency in the controls, compared with the cases.

Examining the heritability of anal sac gland carcinoma in cocker spaniels

MADAM Colleagues cannot have escaped the media interest in heritable diseases of pedigree dogs that has arisen following a recent documentary on the issue. There is known to be a heritable risk of neoplasia in humans for specific cancer types. Strong epidemiological evidence now exists to indicate that there is an elevated risk of neoplasia of the anal sac glands particularly in spaniel breeds (Polton and others 2006). I am writing to inform your readers of an ongoing investigation to define the heritability of anal sac gland carcinoma in cocker spaniels. English cocker spaniels, and to a lesser extent springer and cavalier King Charles spaniels, are at higher risk of developing anal sac gland tumours than other dogs. This conclusion is based upon the analysis of large numbers of cases of anal sac gland carcinomas using data from veterinary pathology laboratories (Finn Pathologists, Diss, UK, Abbey Veterinary Services, Newton Abbott, UK and Animal Health Trust Diagnostic Services, Newmarket, UK) and breed incidence data from Pedigree Masterfoods’ Pet Ownership Survey 1998, The UK Kennel Club registrations 1995-2004 and pathology laboratory databases (Finn Pathologists and Animal Health Trust) (Polton and others 2006). A joint project is currently being undertaken by Gerry Polton of North Downs Specialist Referrals, Surrey, UK and David Sargan of Cambridge University Veterinary School, Cambridge, UK. The aims of this project are To use pedigree analysis to establish whether there is an inherited risk of the development of anal sac gland carcinomas in English cocker spaniels. To use genotypic analysis to establish a specific genetic cause for the disease. If colleagues have encountered this tumour in an English cocker spaniel, a springer spaniel or a cavalier King Charles spaniel, it would be of great value to this project if a blood sample and/or the affected patient’s pedigree certificate could be submitted for inclusion in the analyses. For genotypic analyses, 5ml whole blood in EDTA is requested. If blood is obtained, this should be done in accordance with the local rules governing sample collection for scientific procedures. In the UK this means that blood could only be used if venepuncture was already going to be performed for other reasons, for instance routine haematology or serum calcium concentration determination. Blood can be shipped within the EU without legal implications. For transfer of samples from outside the EU please contact Gerry Polton first. For further information or to submit blood or pedigrees please contact Gerry Polton at North Downs Specialist Referrals, Friesian Building 3&4, Brewerstreet Dairy Business Park, Brewer Street, Bletchingley, Surrey RH1 4QP, UK. Tel: +44 (0) 1883 741440, Fax: +44 (0) 1883 347030 E-mail: gerrypolton@gmail.com website: www.ndsr.co.uk

A Case of Anal Gland Carcinoma Accompanied by Pagetoid Spread

A Case of Anal Gland Carcinoma Accompanied by Pagetoid Spread

Immunophenotypic Characteristics of Anal Gland Carcinoma

Immunophenotypic Characteristics of Anal Gland Carcinoma

Immunophenotypic characteristics of anal gland carcinoma.

Immunophenotypic characteristics of anal gland carcinoma.

Quantitative analysis in spontaneous canine anal sac gland adenomas and carcinomas

Stained cytological specimens from 7 canine anal sac gland adenomas and 11 canine anal sac gland carcinomas were analyzed by computer-assisted nuclear morphometry. In each case, the nuclei of at least 100 neoplastic cells were measured, and the mean nuclear area (MNA), mean nuclear perimeter (MNP), mean nuclear diameter (MND) and nuclear roundness (NR) were calculated. The study aimed to evaluate (1) the possibility of using nuclear cytomorphometry as an auxiliary diagnostic method to differentiate between canine anal sac gland adenomas and adenocarcinomas, and (2) the prognostic value of nuclear morphometry in canine anal sac gland adenocarcinomas. The results indicated that (1) MNA, MNP, MND and NR could be used as effective auxiliary tools for differential diagnosis between canine anal sac gland adenomas and adenocarcinomas, and (2) MNA, MNP and MND are reliable prognostic indicators for canine anal sac gland adenocarcinomas.

Expression of E‐cadherin in canine anal sac gland carcinoma and its association with survival*

The objective of this study was to determine whether an association could be demonstrated between survival and the expression of the adhesion molecule E-cadherin by the neoplastic cells in a group of dogs with anal sac gland carcinomas (ASGCs). Archived formalin-fixed, paraffin wax-embedded primary tumour specimens were obtained for 36 cases of canine ASGC with known clinical management and survival data. Immunohistochemical methods were used to evaluate E-cadherin expression by the neoplastic cells and data were evaluated for an association between E-cadherin expression and survival. On univariate analysis, the median survival time for cases with tumours expressing E-cadherin in more than 75% of cells was significantly greater than that for cases with tumours expressing E-cadherin in fewer than 75% of cells (1168 versus 448 days, P = 0.0246). Both E-cadherin expression and presence or absence of distant metastases were significantly associated with survival on multivariate analysis. This study demonstrates that expression of E-cadherin at the cytoplasmic membrane in canine ASGCs is variable and potentially predictive of survival.

Immunophenotypic characterization of anal gland carcinoma: Loss of p63 and cytokeratin 5/6

Anal gland carcinoma (AGC) is a rare perianal invasive cancer composed of tubular glands lined by cuboidal epithelium. The clinical features and histogenesis of AGC are not well understood and its origin from anal glands is often difficult to prove. Little is known about immunophenotypic features of AGC that could be useful in establishing the diagnosis. This study evaluated the immunohistochemical profile of 2 cases of AGC in comparison to anal glands from 11 hemorrhoidectomy specimens. Sections from the specimens were routinely processed and immunostained using commercial antibodies to cytokeratin (CK) 7, CK20, CK5/ 6, p63, CDX2, smooth muscle actin, calponin, heavy chain smooth muscle myosin, p53, and p16. In case 1 of AGC, radiation and chemotherapy preceded an abdominoperineal resection. In biopsies from this case, the neoplastic anal glands had a tubular pattern, whereas most glands in the resection specimen exhibited mucinous features. The histologic pattern in case 2 was tubular. Normal anal glands showed immunoreactivity for myoepithelial and basal cell markers CK5/6 and p63 in basal and parabasal cell layers and for CK7 in superficial cell layers. In contrast, both cases of AGC were negative for CK5/6 and p63 and were diffusely positive for CK7. Normal glands and both cases of AGC were negative for the intestinal differentiation marker CDX2, CK20, smooth muscle actin, calponin, smooth muscle myosin heavy chain, p16, and p53. Our data suggest that loss of p63 and CK5/6 expression is a feature of AGC. Anal gland carcinoma shares negativity for CDX2 and CK7+/CK20- profile with normal anal glands. No evidence of myoepithelial cells was found in normal or malignant anal glands. These data may be useful in establishing the diagnosis of AGC.

Immunophenotypic Characterization of Anal Gland Carcinoma: Loss of p63 and Cytokeratin 5/6

Anal gland carcinoma (AGC) is a rare perianal invasive cancer composed of tubular glands lined by cuboidal epithelium. The clinical features and histogenesis of AGC are not well understood and its origin from anal glands is often difficult to prove. Little is known about immunophenotypic features of AGC that could be useful in establishing the diagnosis. This study evaluated the immunohistochemical profile of 2 cases of AGC in comparison to anal glands from 11 hemorrhoidectomy specimens. Sections from the specimens were routinely processed and immunostained using commercial antibodies to cytokeratin (CK) 7, CK20, CK5/ 6, p63, CDX2, smooth muscle actin, calponin, heavy chain smooth muscle myosin, p53, and p16. In case 1 of AGC, radiation and chemotherapy preceded an abdominoperineal resection. In biopsies from this case, the neoplastic anal glands had a tubular pattern, whereas most glands in the resection specimen exhibited mucinous features. The histologic pattern in case 2 was tubular. Normal anal glands showed immunoreactivity for myoepithelial and basal cell markers CK5/6 and p63 in basal and parabasal cell layers and for CK7 in superficial cell layers. In contrast, both cases of AGC were negative for CK5/6 and p63 and were diffusely positive for CK7. Normal glands and both cases of AGC were negative for the intestinal differentiation marker CDX2, CK20, smooth muscle actin, calponin, smooth muscle myosin heavy chain, p16, and p53. Our data suggest that loss of p63 and CK5/6 expression is a feature of AGC. Anal gland carcinoma shares negativity for CDX2 and CK7+/CK20- profile with normal anal glands. No evidence of myoepithelial cells was found in normal or malignant anal glands. These data may be useful in establishing the diagnosis of AGC.

Anal sac gland carcinoma in cocker spaniels

Veterinary RecordVolume 160, Issue 7 p. 244-244 Letter Anal sac gland carcinoma in cocker spaniels Gerry Polton, Gerry Polton Davies Veterinary Specialists Manor Farm Business Park, Higham Gobion, Hitchin, Hertfordshire, SG5 3HRSearch for more papers by this author Gerry Polton, Gerry Polton Davies Veterinary Specialists Manor Farm Business Park, Higham Gobion, Hitchin, Hertfordshire, SG5 3HRSearch for more papers by this author First published: 17 February 2007 https://doi.org/10.1136/vr.160.7.244-aRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Volume160, Issue7February 2007Pages 244-244 RelatedInformation

Examining the risk of anal sac gland carcinoma in cocker spaniels

MADAM Unfortunately it would appear that English cocker spaniels (and to a lesser extent springer and cavalier King Charles spaniels) are at higher risk of developing anal sac gland tumours than other dogs. This conclusion is based upon the analysis of large numbers of cases of anal sac gland carcinomas using data from veterinary pathology laboratories (Finn Pathologists, Diss, UK; Abbey Veterinary Services, Newton Abbott, UK and Animal Health Trust Diagnostic Services, Newmarket, UK) and breed incidence data from Pedigree Masterfoods’ Pet Ownership Survey 1998, The UK Kennel Club registrations 1995-2004 and pathology laboratory databases (Finn Pathologists and Animal Health Trust). This raises the concern that there is a degree of heritable risk. Other possibilities include environmental or lifestyle factors. Gerry Polton of Davies Veterinary Specialists and David Sargan of Cambridge University Veterinary School are currently investigating this problem. Pedigree analysis will be used to establish whether there is an inherited risk of the development of anal sac gland carcinomas in English cocker spaniels. If colleagues have encountered this tumour in English cockers, it could be of great value to this project if copies of the affected patient’s pedigree certificate could be submitted for inclusion in the analysis. We would be quite happy to contact owners to explain the purpose of this project and to request pedigree information if colleagues were able to provide appropriate contact details. For further information or to submit a pedigree please contact Gerry Polton.

Wide local excision and split-thickness skin graft for circumferential Paget's disease of the anus

Background Our aim was to evaluate the results of wide local excision followed by split-thickness skin graft for circumferential perianal Paget's disease. Methods Between 1995 and 1999, 5 patients with perianal Paget's disease underwent wide local excision of the disease. The circumferential involvement was documented by preoperative mapping. Standard orthograde bowel cleansing and oral antibiotics were given the day prior to surgery. The wound was allowed to granulate and confirmation of negative margins was obtained on permanent sections taken from the excised specimens. On postoperative day 4, split-thickness skin grafts harvested from the lateral thigh were applied (surface using area ranging from 100 cm 2 to 240 cm 2). The grafts were secured in place with a 3-0 Vicryl suture and covered with a pressure dressing. After 4 days of bedrest, the dressing was taken down under anesthesia (day 8). Results Graft survival was 100% in 3 patients, 80% in 1 patient, and 70% in another. Postoperatively, clinical follow-up was conducted at 3-month intervals. In 2 patients, anal stenosis developed after the operation and resolved by gentle self-dilation. At a mean follow-up of 42 months (range 21 to 78), adequate cosmetic and functional results were obtained. Recurrence of Paget's disease has occurred in 1 patient (at 21 months) and an invasive anal gland carcinoma was found in 1 patient (at 48 months). Conclusions Wide local excision and circumferential split-thickness skin grafting achieves adequate cosmetic and functional results without the need for diverting colostomy. However, there is a considerable recurrence rate after surgery, which warrants very close follow-up to rule out recurrent disease or underlying adenocarcinoma.

Tailgut cyst associated with a pilonidal sinus: an unusual case and a review.

Tailgut cysts are rare congenital abnormalities in the retrocaecal/presacral region. Clinical diagnosis is difficult and delayed and they can present in childhood and adult life with a variety of clinical symptoms and complications. Differential diagnoses include, rectal duplication cysts, cystic teratoma, epidermal cyst, anal gland cyst and anal gland carcinoma. Magnetic resonance imaging has recently become the modality of choice to image these cysts. Although Tailgut cysts rarely undergo malignant transformation, early surgical resection is presently considered the treatment of choice. Here we report the case of a 34 year old gentleman with a Tailgut cyst associated with a Pilonidal sinus, and review of the literature. We believe that the high incidence of complications associated with operations in the presacral region should be weighed against the generally benign course of these lesions, especially with the quality of modern imaging technology.

Adenocarcinoma arising within a Crohn's‐related anorectal fistula: a form of anal gland carcinoma?

Adenocarcinoma arising within a Crohn's‐related anorectal fistula: a form of anal gland carcinoma?

Anal gland carcinoma.

Anal gland carcinoma is a rare entity. The authors conducted a joint study of cases coded as definite or possible anal gland carcinoma from the archives of the Armed Forces Institute of Pathology and the Canadian Reference Center for Cancer Pathology. Seven cases of potential anal gland carcinoma were identified from the Canadian files and 12 from the Armed Forces Institute of Pathology archives. Of these 19 cases, 14 had adequate material to allow clinical, histologic, and immunohistochemical analysis. Seven of these 14 cases met a modified World Health Organization (WHO) definition of anal gland carcinoma. The mean age of these patients was 66 years (range, 60-72 years), with a male-to-female ratio of 6:1. The tumors were composed of haphazardly dispersed, small glands with scant mucin production that invaded the wall of the anorectal area with no obvious intraluminal component observed clinically or microscopically. Immunohistochemical studies were performed on all seven of these cases, revealing cytokeratin (CK) 7+/CK 20- expression in six cases, and CK 7+/CK 20+ expression in one case. The remaining seven cases showed no intraluminal component but did not meet a modified WHO definition of anal gland carcinoma. This group included three mucinous adenocarcinomas (two clinically arising in anal fistulas), all of which were CK 7+/CK 20+, and a rectal-type adenocarcinoma that was CK 7-/CK 20+. There was also a tumor interpreted as probable rectal-type adenocarcinoma that was CK 7+/CK 20+, and a tumor interpreted as probable squamous cell carcinoma that was CK 7-/CK 20-. The seventh tumor in this group, which could not be classified, was CK 7+/CK 20-. A useful and discriminating definition of anal gland carcinoma is an anal canal tumor composed of haphazardly dispersed, small glands with scant mucin production invading the wall of the anorectal area without an intraluminal component. The glands are positive for CK 7.