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==Diagnostic Studies==
==Diagnostic Studies==
'''Laboratory Studies'''
'''Laboratory Studies'''
There are no diagnostic lab findings associated with anal cancer.
There are no diagnostic lab findings associated with anal cancer.


'''MRI'''
'''MRI'''
Pelvic MRI may be diagnostic of anal cancer.
Pelvic MRI may be diagnostic of anal cancer.
'''CT'''
'''CT'''
CT may be helpful in the diagnosis and staging of anal cancer.
CT may be helpful in the diagnosis and staging of anal cancer.
'''Ultrasound'''
'''Ultrasound'''
Endoanal ultrasound may be helpful in the diagnosis, staging, determination of the depth of penetration, and to monitor the response to chemo and/or radiation therapy to anal cancer.
Endoanal ultrasound may be helpful in the diagnosis, staging, determination of the depth of penetration, and to monitor the response to chemo and/or radiation therapy to anal cancer.
'''Other Imaging Studies'''
'''Other Imaging Studies'''
[[PET]]-[[CT]] may be helpful in anal cancer staging.<ref name="radiopaedia">http://radiopaedia.org/articles/anal-cancer  </ref>
[[PET]]-[[CT]] may be helpful in anal cancer staging.<ref name="radiopaedia">http://radiopaedia.org/articles/anal-cancer  </ref>


'''Other Diagnostic Imaging'''
'''Other Diagnostic Imaging'''
[[Anoscopy]], [[proctoscopy]], and biopsy maybe helpful in the diagnosis of anal cancer.
[[Anoscopy]], [[proctoscopy]], and biopsy maybe helpful in the diagnosis of anal cancer.
==References==
==References==



Revision as of 21:04, 10 September 2015

Anal cancer Microchapters

Home

Patient Info

Overview

Historical Perspective

Classification

Pathophysiology

Epidemiology & Demographics

Risk Factors

Screening

Causes

Differentiating Anal cancer from other Diseases

Natural History, Complications and Prognosis

Diagnosis

Staging

History and Symptoms

Physical Examination

Laboratory Findings

MRI

CT

Ultrasound

Other Imaging studies

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamad Alkateb, MBBCh [2]

Overview

Anal cancer is a type of cancer which arises from the anus, the distal orifice of the gastrointestinal tract. It is a distinct entity from the more common colorectal cancer. The etiology, risk factors, clinical progression, staging, and treatment are all different. Anal cancer is typically a squamous cell carcinoma that arises near the squamocolumnar junction and its often linked to human papillomavirus (HPV) infection. It may be keratinizing (basaloid) or non-keratinizing (cloacogenic). Other types of anal cancer are adenocarcinoma, lymphoma, sarcoma or melanoma. Treatment depends on the stage of the disease at the time of diagnosis.

Classification

Anal cancer may be classified according to histology into four subtypes: squamous cell carcinoma, adenocarcinoma, lymphoma, and sarcoma.

Pathophysiology

Anal cancer most commonly arises from squamous cells at the squamocolumnar junction. Other types of anal cancer are adenocarcinoma, lymphoma, and sarcoma.

Epidemiology and Demographics

In 2008-2012, the incidence of anal cancer was estimated to be 1.8 cases per 100,000 individuals in the US.

Risk Factor

The most potent risk factor in the development of anal cancer is Human Papillomavirus (HPV). Other risk factors include receptive anal intercourse with multiple sexual partners, smoking, and immunosuppression.

Screening

Screening for anal cancer by pap smear is suggested among HIV-positive patients and homosexual men.

Causes

Squamous carcinoma of the anus may be caused by HPV infection.

Differential Diagnosis

Anal cancer must be differentiated from other diseases that cause anal pain, anal pressure, and hematochezia, such as, anal fissure, and neoplastic ulcers.

Natural History, Complication, and Prognosis

Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary. The three major prognostic factors are site (anal canal vs. perianal skin), size (primary tumors <2 cm in size have better prognoses), and lymph nodes involvement.[1]

Staging

The staging of Anal cancer is based on the TNM staging system [1]

History and Symptoms

Symptoms of anal cancer include pain or pressure in the anus or rectum, anal itching and anal discharge.

Physical Examination

Common physical examination findings of anal cancer include a lump near the anus and rectal bleeding.

Diagnostic Studies

Laboratory Studies

There are no diagnostic lab findings associated with anal cancer.

MRI

Pelvic MRI may be diagnostic of anal cancer. CT

CT may be helpful in the diagnosis and staging of anal cancer. Ultrasound

Endoanal ultrasound may be helpful in the diagnosis, staging, determination of the depth of penetration, and to monitor the response to chemo and/or radiation therapy to anal cancer. Other Imaging Studies

PET-CT may be helpful in anal cancer staging.[2]

Other Diagnostic Imaging

Anoscopy, proctoscopy, and biopsy maybe helpful in the diagnosis of anal cancer.

References

  1. 1.0 1.1 National Cancer Institute. Physician Data Query Database 2015.http://www.cancer.gov/types/anal/hp/anal-treatment-pdq
  2. http://radiopaedia.org/articles/anal-cancer


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