Endoscopic submucosal dissection (ESD) for anal high-grade intraepithelial neoplasia: a case report

Andrej Wagner; Daniel Neureiter; Josef Holzinger; Tobias Kiesslich; Eckhard Klieser; Frieder Berr

doi:10.1055/a-0578-9059

Zeitschrift für Gastroenterologie, Table of Contents

Z Gastroenterol 2018; 56(05): 495-498
DOI: 10.1055/a-0578-9059

Kasuistik

Endoscopic submucosal dissection (ESD) for anal high-grade intraepithelial neoplasia: a case report

Endoskopische Submukosadissektion (ESD) für hochgradige anale intraepitheliale Neoplasie: ein Fallbericht

Andrej Wagner

¹Department of Internal Medicine I, Paracelsus Medical University/Salzburger Landeskliniken (SALK), Salzburg, Austria

,

Daniel Neureiter

²Institute of Pathology, Paracelsus Medical University/Salzburger Landeskliniken (SALK), Salzburg, Austria

,

Josef Holzinger

³Department of Surgery, Paracelsus Medical University/Salzburger Landeskliniken (SALK), Salzburg, Austria

,

Tobias Kiesslich

⁴Laboratory for Tumour Biology and Experimental Therapies (TREAT), Institute of Physiology and Pathophysiology, Paracelsus Medical University, Salzburg, Austria

,

Eckhard Klieser

²Institute of Pathology, Paracelsus Medical University/Salzburger Landeskliniken (SALK), Salzburg, Austria

,

Frieder Berr

¹Department of Internal Medicine I, Paracelsus Medical University/Salzburger Landeskliniken (SALK), Salzburg, Austria

› Author Affiliations

Abstract

Anal intraepithelial neoplasia (AIN) is a precursor of anal carcinoma. Conventional therapy is based on topical and local ablative approaches. However, the recurrence rates are very high, leading to repetitive treatment sessions and need for long-term surveillance. Endoscopic submucosal dissection (ESD) is an established treatment for malignant early neoplasias of the gastrointestinal tract, especially in the esophagus, stomach, and colorectum. Japanese centers have reported few cases of ESD for early anal carcinoma. We report a case of high-grade AIN diagnosed with magnifying narrow-band imaging and chromoendoscopy that was resected R0 with ESD en bloc.

Zusammenfassung

Die anale intraepitheliale Neoplasie (AIN) ist die Vorläuferläsion des Analkarzinoms. Bisherige Therapieoptionen beschränkten sich auf topische und ablative Verfahren, denen eine sehr hohe Rezidivrate gemeinsam ist. Dies macht engmaschige Verlaufsuntersuchungen und Nachbehandlungen erforderlich. Die Endoskopische Submukosadissektion (ESD) hat sich als Therapie von malignitätsverdächtigen Frühneoplasien des Gastrointestinaltraktes im Ösophagus, Magen und Kolon etabliert. Zur ESD von analen Frühkarzinomen liegen nur einzelne Fallberichte aus japanischen Zentren vor. Der vorliegende Fallbericht stellt die R0 Resektion einer hochgradigen AIN mittels en-bloc ESD nach umfassender Diagnostik mit hochauflösender Videoendoskopie vor.

Schlüsselwörter

Endoskopische Submukosadissektion - anale intraepitheliale Neoplasie - Resektion

Key words

endoscopic submucosal dissection - anal intraepithelial neoplasia - resection

Full Text

References

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