Curbside Consultation in GI Cancer for the Gastroenterologist: 49 Clinical Questions

Douglas G. Adler, MD

Question 44: A 55-Year-Old Man Presents With Rectal Bleeding. A Digital Rectal Exam Reveals A Firm 1-Cm Perianal Lesion. Biopsy Of This Lesion Is Consistent With Squamous Cell Carcinoma. How Do You Manage This Patient? (continued)

Selvi Thirumurthi, MD, MS

The most common type of anal cancer arises from the squamous epithelium of the distal anal canal. Cancers originating from the proximal anal canal are less common and arise from columnar epithelium. The treatment of these anal adenocarcinomas is very similar to rectal adenocarcinomas. Our patient’s biopsy reveals squamous cell carcinoma of the anal canal, and we will focus on this clinical entity. The most common presenting symptom of anal cancer is anal bleeding followed by the sensation of fullness or a mass. Up to 20% of patients with anal cancer may be asymptomatic. Risk factors…
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