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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Definitions
- Anal carcinoma
- Uncommon cancer of anal canal and perianal skin, strongly associated with human papilloma virus
- Similar risk factors to genital cancers
- Majority are squamous cell carcinoma (adenocarcinoma rare)
- Regional nodal metastases common
- Distant metastases uncommon, usually liver if present
- Above dentate line (upper 2/3 of anal canal)
- Columnar epithelium
- Adenocarcinomas (rare)
- Treated similarly to rectal adenocarcinomas
- Supplied by superior rectal artery
- Drained by portal venous circulation
- Lymphatic drainage to perirectal and paravertebral lymph nodes
- Columnar epithelium
- Below dentate line (lower 1/3 of anal canal)
- Stratified squamous epithelium
- Squamous cell carcinomas
- Supplied by inferior rectal artery
- Drained by systemic circulation
- Lymphatic drainage to inguinal and femoral lymph nodes
- Stratified squamous epithelium
- Uncommon cancer of anal canal and perianal skin, strongly associated with human papilloma virus
- Perianal skin cancers
- Involve anal margin or perianal skin
- Most commonly squamous cell carcinoma
- Often treated similarly to squamous cell carcinoma of anus (chemoradiotherapy), as it is difficult to delineate anal margin vs. skin
- Anal carcinoma
IMAGING
F-18 FDG PET/CT
CT
MR
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Ladbury C et al: Anal cancer in the era of dose painted intensity modulated radiation therapy: Implications for regional nodal therapy. Semin Radiat Oncol. 29(2):137-43, 2019
- Ciombor KK et al: Diagnosis and diagnostic imaging of anal canal cancer. Surg Oncol Clin N Am. 26(1):45-55, 2017
- Houard C et al: Role of 18F-fluorodeoxyglucose positron emission tomography-computed tomography in post-treatment evaluation of anal carcinoma. J Nucl Med. 58(9):1414-20, 2017
- Gauthé M et al: Role of fluorine 18 fluorodeoxyglucose positron emission tomography/computed tomography in gastrointestinal cancers. Dig Liver Dis. 47(6):443-54, 2015
- Jones M et al: The role of FDG-PET in the initial staging and response assessment of anal cancer: A systematic review and meta-analysis. Ann Surg Oncol. 22(11):3574-81, 2015
- Matalon SA et al: Anorectal cancer: critical anatomic and staging distinctions that affect use of radiation therapy. Radiographics. 35(7):2090-107, 2015
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Definitions
- Anal carcinoma
- Uncommon cancer of anal canal and perianal skin, strongly associated with human papilloma virus
- Similar risk factors to genital cancers
- Majority are squamous cell carcinoma (adenocarcinoma rare)
- Regional nodal metastases common
- Distant metastases uncommon, usually liver if present
- Above dentate line (upper 2/3 of anal canal)
- Columnar epithelium
- Adenocarcinomas (rare)
- Treated similarly to rectal adenocarcinomas
- Supplied by superior rectal artery
- Drained by portal venous circulation
- Lymphatic drainage to perirectal and paravertebral lymph nodes
- Columnar epithelium
- Below dentate line (lower 1/3 of anal canal)
- Stratified squamous epithelium
- Squamous cell carcinomas
- Supplied by inferior rectal artery
- Drained by systemic circulation
- Lymphatic drainage to inguinal and femoral lymph nodes
- Stratified squamous epithelium
- Uncommon cancer of anal canal and perianal skin, strongly associated with human papilloma virus
- Perianal skin cancers
- Involve anal margin or perianal skin
- Most commonly squamous cell carcinoma
- Often treated similarly to squamous cell carcinoma of anus (chemoradiotherapy), as it is difficult to delineate anal margin vs. skin
- Anal carcinoma
IMAGING
F-18 FDG PET/CT
CT
MR
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Ladbury C et al: Anal cancer in the era of dose painted intensity modulated radiation therapy: Implications for regional nodal therapy. Semin Radiat Oncol. 29(2):137-43, 2019
- Ciombor KK et al: Diagnosis and diagnostic imaging of anal canal cancer. Surg Oncol Clin N Am. 26(1):45-55, 2017
- Houard C et al: Role of 18F-fluorodeoxyglucose positron emission tomography-computed tomography in post-treatment evaluation of anal carcinoma. J Nucl Med. 58(9):1414-20, 2017
- Gauthé M et al: Role of fluorine 18 fluorodeoxyglucose positron emission tomography/computed tomography in gastrointestinal cancers. Dig Liver Dis. 47(6):443-54, 2015
- Jones M et al: The role of FDG-PET in the initial staging and response assessment of anal cancer: A systematic review and meta-analysis. Ann Surg Oncol. 22(11):3574-81, 2015
- Matalon SA et al: Anorectal cancer: critical anatomic and staging distinctions that affect use of radiation therapy. Radiographics. 35(7):2090-107, 2015
