CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(09): E1130-E1133
DOI: 10.1055/a-0584-7060
Case report
Owner and Copyright © Georg Thieme Verlag KG 2018

Endoscopic submucosal dissection for early squamous cell carcinoma in the anal canal and Lugol chromoendoscopy for assessment of the lateral margin

Takeshi Uozumi
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Tetsuya Sumiyoshi
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Hitoshi Kondo
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Takeyoshi Minagawa
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Ryoji Fujii
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Masahiro Yosida
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Kaho Tokuchi
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Takuya Mizukami
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Koutarou Morita
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Hideyuki Ihara
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Yutaka Okagawa
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Toshizo Takayama
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Shutaro Ooiwa
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Michiaki Hirayama
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Yumiko Oyamada
2   Department of Pathology, Tonan Hospital, Sapporo, Japan
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Publikationsverlauf

submitted 15. Dezember 2017

accepted after revision 23. Januar 2018

Publikationsdatum:
11. September 2018 (online)

Abstract

A 66-year-old man underwent follow-up colonoscopy after colon polypectomy. The retroflexed view of the anal canal with white-light imaging revealed a whitish, slightly elevated lesion on the dentate line and an ill-defined flat lesion. A biopsy of the whitish elevation revealed squamous cell carcinoma (SCC), and endoscopic submucosal dissection (ESD) was planned. The lateral margin of the SCC was identified by spraying with Lugol’s iodine, and the tumor was resected en bloc with no complications. The pathological findings were SCC in situ with parakeratosis in the whitish elevation and high-grade intraepithelial neoplasia in the ill-defined flat lesion, which exhibited a wide iodine-unstained area by chromoendoscopy. Early SCC in the anal canal is a rare gastrointestinal cancer, and Lugol chromoendoscopy helped visualize the tumor margin for ESD.

 
  • References

  • 1 Nelson RA, Levine AM, Bernstein L. et al. Changing patterns of anal canal carcinoma in the United States. J Clin Oncol 2013; 31: 1569-1575
  • 2 Ryan DP, Compton CC, Mayer RJ. Carcinoma of the anal canal. N Engl J Med 2000; 342: 792-800
  • 3 Jay N, Berry JM, Miaskowski C. et al. Colposcopic characteristics and Lugol’s staining differentiate anal high-grade and low-grade squamous intraepithelial lesions during high resolution anoscopy. Papillomavirus Res 2015; 1: 101-108
  • 4 Tsuji S, Doyama H, Yamada S. et al. Endoscopic submucosal dissection of a squamous cell carcinoma in situ in the anal canal diagnosed by magnifying endoscopy with narrow-band imaging. Clin J Gastroenterol 2014; 7: 233-237
  • 5 Ito T, Morita S, Shimeno N. et al. The prospect of endoscopic submucosal dissection for early anal canal squamous cell carcinoma. Clin J Gastroenterol 2016; 9: 384-388
  • 6 Tamaru Y, Oka S, Tanaka S. et al. Early squamous cell carcinoma of the anal canal resected by endoscopic submucosal dissection. Case Rep Gastroenterol 2015; 9: 120-125
  • 7 Yamaguchi T, Moriya Y, Fujii T. et al. Anal canal squamous-cell carcinoma in situ, clearly demonstrated by indigo carmine dye spraying. Dis Colon Rectum 2000; 43: 1161-1163