Evaluation and Management of Anal Intraepithelial Neoplasms

Area of Science:

• Oncology
• Infectious Diseases
• Gastroenterology

Background:

• Management of high-grade squamous intraepithelial lesions (HSIL) in HIV-positive individuals requires vigilant surveillance.
• Anal intraepithelial neoplasia is a significant concern in men who have sex with men (MSM) with long-standing HIV infection.
• Antiretroviral therapy (ART) adherence is critical for managing HIV and associated comorbidities.

Observation:

• A 62-year-old man with a 10-year history of HIV on ART presented with HSIL.
• The lesion was detected during routine surveillance using high-resolution anoscopy (HRA).
• The patient identified as a man who has sex with men (MSM).

Findings:

• Electrocautery ablation was employed as the treatment modality for the anal HSIL.
• Post-treatment HRA confirmed the complete resolution of the HSIL.
• Successful management of HSIL was achieved with a minimally invasive procedure.

Implications:

• This case underscores the efficacy of electrocautery ablation for HSIL in HIV-positive MSM.
• Regular HRA surveillance is vital for early detection and management of anal neoplasia in this population.
• Timely intervention can prevent progression to invasive anal cancer.