Endoscopic Ultrasound-Guided Fine Needle Aspiration (EUS-FNA) Diagnosis of Recurrent Anal Cancer after Chemoradiation and Negative Forceps Biopsies: A Case Report

A 69-year-old woman with a history of uT2 N0 post-treated anal squamous cell cancer (SCC) presented for EUS for perianal pain. Two months prior, a digital rectal examination was significant for an indurated lesion on the left lateral rectal wall just proximal to the dentate line. A sigmoidoscopy rev...

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Main Authors: Julia Leblanc, Pradermchai Kongkam
Format: Article
Language:English
Published: SAGE Publishing 2009-01-01
Series:Clinical Medicine Insights: Oncology
Online Access:https://doi.org/10.4137/CMO.S993
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spelling doaj-fdbb88c2b9e64005b8ccbd8283b3c0f42020-11-25T03:18:05ZengSAGE PublishingClinical Medicine Insights: Oncology1179-55492009-01-01310.4137/CMO.S993Endoscopic Ultrasound-Guided Fine Needle Aspiration (EUS-FNA) Diagnosis of Recurrent Anal Cancer after Chemoradiation and Negative Forceps Biopsies: A Case ReportJulia Leblanc0Pradermchai Kongkam1Indiana University Medical Center, Division of Gastroenterology and Hepatology.Indiana University Medical Center, Division of Gastroenterology and Hepatology.A 69-year-old woman with a history of uT2 N0 post-treated anal squamous cell cancer (SCC) presented for EUS for perianal pain. Two months prior, a digital rectal examination was significant for an indurated lesion on the left lateral rectal wall just proximal to the dentate line. A sigmoidoscopy revealed mild narrowing of the anal canal and an ulcerated friable mucosa in the same area. A biopsy demonstrated ulceration without malignancy. EUS showed a hypoechoic, non-circumferential, left-sided distal rectal mass. EUS-FNA was performed. Cytology demonstrated poorly differentiated SCC. This was confirmed by subsequent surgical resection. While endoscopic biopsy of suspected anal recurrences is usually sufficient, histologic or cytologic confirmation are necessary, as radiation-induced changes are difficult to differentiate from tumor recurrence. This case demonstrates that EUS-FNA is useful in surveillance of anal SCC when there is a high clinical suspicion of recurrence.https://doi.org/10.4137/CMO.S993
collection DOAJ
language English
format Article
sources DOAJ
author Julia Leblanc
Pradermchai Kongkam
spellingShingle Julia Leblanc
Pradermchai Kongkam
Endoscopic Ultrasound-Guided Fine Needle Aspiration (EUS-FNA) Diagnosis of Recurrent Anal Cancer after Chemoradiation and Negative Forceps Biopsies: A Case Report
Clinical Medicine Insights: Oncology
author_facet Julia Leblanc
Pradermchai Kongkam
author_sort Julia Leblanc
title Endoscopic Ultrasound-Guided Fine Needle Aspiration (EUS-FNA) Diagnosis of Recurrent Anal Cancer after Chemoradiation and Negative Forceps Biopsies: A Case Report
title_short Endoscopic Ultrasound-Guided Fine Needle Aspiration (EUS-FNA) Diagnosis of Recurrent Anal Cancer after Chemoradiation and Negative Forceps Biopsies: A Case Report
title_full Endoscopic Ultrasound-Guided Fine Needle Aspiration (EUS-FNA) Diagnosis of Recurrent Anal Cancer after Chemoradiation and Negative Forceps Biopsies: A Case Report
title_fullStr Endoscopic Ultrasound-Guided Fine Needle Aspiration (EUS-FNA) Diagnosis of Recurrent Anal Cancer after Chemoradiation and Negative Forceps Biopsies: A Case Report
title_full_unstemmed Endoscopic Ultrasound-Guided Fine Needle Aspiration (EUS-FNA) Diagnosis of Recurrent Anal Cancer after Chemoradiation and Negative Forceps Biopsies: A Case Report
title_sort endoscopic ultrasound-guided fine needle aspiration (eus-fna) diagnosis of recurrent anal cancer after chemoradiation and negative forceps biopsies: a case report
publisher SAGE Publishing
series Clinical Medicine Insights: Oncology
issn 1179-5549
publishDate 2009-01-01
description A 69-year-old woman with a history of uT2 N0 post-treated anal squamous cell cancer (SCC) presented for EUS for perianal pain. Two months prior, a digital rectal examination was significant for an indurated lesion on the left lateral rectal wall just proximal to the dentate line. A sigmoidoscopy revealed mild narrowing of the anal canal and an ulcerated friable mucosa in the same area. A biopsy demonstrated ulceration without malignancy. EUS showed a hypoechoic, non-circumferential, left-sided distal rectal mass. EUS-FNA was performed. Cytology demonstrated poorly differentiated SCC. This was confirmed by subsequent surgical resection. While endoscopic biopsy of suspected anal recurrences is usually sufficient, histologic or cytologic confirmation are necessary, as radiation-induced changes are difficult to differentiate from tumor recurrence. This case demonstrates that EUS-FNA is useful in surveillance of anal SCC when there is a high clinical suspicion of recurrence.
url https://doi.org/10.4137/CMO.S993
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