[Malignant epidermoid tumors of the anus. Etiopathogenesis and clinical aspects]

Malignant squamous tumors of the anus (MSTA) are most often carcinomas of the anus (80 to 85%) but remain rare. They occur above all in women between the age of 45 and 70. Three groups are considered to be high-risk: passive homosexuals, individuals with anal condylomas (in particular HIV+) and women with genital dysplasias or carcinomas. The presentation of MSTA is variable and often quite non-specific: bleeding, pain, pruritus, discharge. Proctological examination reveals an ulcerated lesion, proliferative or infiltrating. The diagnosis is confirmed by biopsy. Clinical (often under general anesthesia) and paraclinical (endoscopy, CT scan and endo-anal ultrasonography) evaluation is necessary. This involves three levels: local (enabling determination of spread in terms of height and circumference and/or infiltration of deep layers), regional (detection of inguinal and/or pelvirectal lymphadenopathy) and general (detection of bone, liver or lung metastases). This evaluation enables classification of the tumor, forming the basis of management choices and defining its prognosis.