A CASE OF SQUAMOUS CELL CARCINOMA OF ANAL CANAL OCCURRING 10 YEARS AFTER HYSTERECTOMY FOR UTERINE CERVICAL CANCER

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Abstract

Anal cancer is rare tumor, accounting for ∼1% of colorectal malignancy in Japan. We report metachronous anal cancer occurred after the treatment of uterine cervix cancer. A 36-year-old woman was referred to our hospital complaining of left supraclavicular node swelling and protruding mass at anus. She had a history of hysterectomy 10 years ago due to early staged uterine cervix cancer (carcinoma in situ) at another hospital. PET-CT and colonoscopy showed apparent tumor from anus to lower rectum (Rb) and multiple hypermetabolic lesions at paraaortic lymph nodes and left supraclavicular lymph node. Interestingly, there were no lesions seen in inguinal lymph nodes. Endoscopic biopsy of anus and fine needle aspiration of her cervical lymph node was positive for squamous carcinoma. After four cycles of the combination chemotherapy with 5-FU and cisplatin (FP), colonoscopy showed a remarkable shrinkage of primary mass but residual tumor at anus. Subsequent PET-CT showed disappearance hypermetabolic uptakes except at anus; therefore, she received additional two cycles of the chemotherapy with concurrent radiotherapy to the pelvis (60 Gy of RT with two cycles of FP). Both of uterine cervical cancer and anal cancer have been discussed in terms of HPV infection. Our experience with the present case suggests that it is necessary to take anal canal cancer as a metachronous cancer into consideration in the course of observations after the treatment of uterine cervical cancer.

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