Anus & perianal area


Carcinoma overview

Last author update: 30 March 2021
Last staff update: 21 April 2021

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PubMed Search: Anus [title] carcinoma "free full text"[sb]

Raul S. Gonzalez, M.D.
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Cite this page: Gonzalez RS. Carcinoma overview. website. Accessed October 3rd, 2023.
Definition / general
  • Carcinoma arising in anus, usually of squamous origin
  • WHO classification includes squamous cell carcinoma, verrucous carcinoma, undifferentiated carcinoma, adenocarcinoma, mucinous adenocarcinoma, neuroendocrine tumor and neuroendocrine carcinoma
  • Per WHO: anal canal tumor "cannot be seen in its entirety, or at all, when gentle traction is placed on the buttocks" but perianal tumor "is found within a 5 cm radius of the anus and is seen completely when gentle traction is placed on the anus"
Essential features
  • Most anal carcinomas are squamous, with HPV as a risk factor
  • Most common in middle aged women
Clinical features
  • Symptoms include rectal / anal bleeding, anal pain or itching, change in bowel habits, feeling of a mass at anal opening
  • Annual screening of at risk populations using anal Pap smear appears effective (JAMA 1999;281:1822)
Prognostic factors
  • Surgery alone for small lesions; advanced tumors may also require chemoradiation (5-fluorouracil / mitomycin) (Curr Oncol Rep 2009;11:186)
Differential diagnosis
Board review style question #1
    What is the most common primary tumor of the anus?

  1. Adenocarcinoma
  2. Basal cell carcinoma
  3. Neuroendocrine carcinoma
  4. Squamous cell carcinoma
Board review style answer #1
D. Squamous cell carcinoma

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Reference: Carcinoma overview
Board review style question #2
    What screening method can be used for patients at high risk of anal carcinoma?

  1. Annual anal Pap smear
  2. Annual colonoscopy
  3. Annual CT scan
  4. Annual MRI scan
Board review style answer #2
A. Annual anal Pap smear

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Reference: Carcinoma overview
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