Anal canal adenocarcinoma. A report of 4 cases

Although rare, adenocarcinoma of the anal canal may be more common than previously thought in populations with a high incidence of peri-anal sepsis. Four such cases are presented and published reports reviewed. To avoid unnecessary delays in diagnosis, the clinician must adopt a high index of suspicion when dealing with chronic peri-anal disease. More regular follow-up examinations and biopsies of suspicious lesions are necessary. Since the origin and histological appearance of these tumours are often not clear cut, both clinician and pathologist must work closely together when correlating their findings. Until recently, the vast majority of cases have been managed surgically, and a concerted effort needs to be made to evaluate the role of chemoradiotherapy and preoperative radiotherapy as therapeutic modalities.