ABSTRACT
Anal adenocarcinoma is a rare tumor, comprising only 3 to 19% of all tumors arising
in the anal canal. The site of origin of anal adenocarcinoma is controversial, but
likely candidates include the anal glands and chronic fistula-in-ano. Signs and symptoms
of anal adenocarcinoma are similar to other benign anorectal conditions, often delaying
accurate diagnosis and potentially compromising outcome. The optimal surgical treatment
remains to be defined, but abdominoperineal resection appears to be indicated in the
majority of cases. Similarly, the role of radiation and chemotherapy remains unclear.
Anecdotal reports suggest that mitomycin-based chemoradiation protocols similar to
Nigro's protocol for squamous cancer of the anal canal may be efficacious as primary
therapy for anal adenocarcinoma. Adjuvant radiation and 5-FU-based chemotherapy similar
to rectal cancer protocols, given either preoperatively or postoperatively, may also
improve local control and survival following surgical resection. Further studies,
however, are needed.
KEYWORD
Adenocarcinoma - anal neoplasms - anal glands
