BACKGROUND Anal canal adenocarcinoma with secondary perianal Paget’s disease(PPD)is clinically rare and exhibits atypical symptoms,often misdiagnosed as benign conditions such as hemorrhoids or perianal eczema,leadin...BACKGROUND Anal canal adenocarcinoma with secondary perianal Paget’s disease(PPD)is clinically rare and exhibits atypical symptoms,often misdiagnosed as benign conditions such as hemorrhoids or perianal eczema,leading to delayed treatment.Further summarization of diagnostic and therapeutic key points,as well as reasons for misdiagnosis,is necessary to enhance clinical awareness.CASE SUMMARY A retrospective analysis was conducted on a 72-year-old female patient with a 2-year history of perianal moisture,pruritus,and hematochezia,who was repeatedly misdiagnosed with mixed hemorrhoids.The diagnosis of anal canal adenocarcinoma with secondary PPD was confirmed through colonoscopy,perianal skin biopsy,and immunohistochemical staining(CK7,CK20,etc.).The patient underwent 3D laparoscopic-assisted abdominoperineal resection(APR)with extended perianal skin excision,achieving negative margins and primary wound healing.No recurrence or metastasis was observed during the 12-month follow-up.CONCLUSION Secondary PPD has a high misdiagnosis rate.Clinicians should maintain a high index of suspicion for elderly patients with prolonged perianal symptoms(e.g.,pruritus,hematochezia>6 months)and promptly perform colonoscopy and immunohistochemical testing for definitive diagnosis.APR combined with extended perianal resection is an effective treatment,and standardized long-term follow-up is crucial for prognosis.展开更多
患者,男,55岁,因右鼻阻伴头痛头昏1年入院。专科检查见右侧鼻腔下鼻道中鼻道及嗅裂区可见一肿物,质地稍韧,触之易出血,边界不清,鼻窦平扫+增强CT示右侧鼻道内可见一团片影,截面3.5 cm×1.6 cm, 考虑为肿瘤性病变,遂行手术切除并做...患者,男,55岁,因右鼻阻伴头痛头昏1年入院。专科检查见右侧鼻腔下鼻道中鼻道及嗅裂区可见一肿物,质地稍韧,触之易出血,边界不清,鼻窦平扫+增强CT示右侧鼻道内可见一团片影,截面3.5 cm×1.6 cm, 考虑为肿瘤性病变,遂行手术切除并做病理检查。本研究经成都市青白江区人民医院医学伦理委员审核批准(2024第15号)并经患者签署知情同意。展开更多
基金Supported by Guangdong Provincial Medical Research Fund General Program,No.B2025209。
文摘BACKGROUND Anal canal adenocarcinoma with secondary perianal Paget’s disease(PPD)is clinically rare and exhibits atypical symptoms,often misdiagnosed as benign conditions such as hemorrhoids or perianal eczema,leading to delayed treatment.Further summarization of diagnostic and therapeutic key points,as well as reasons for misdiagnosis,is necessary to enhance clinical awareness.CASE SUMMARY A retrospective analysis was conducted on a 72-year-old female patient with a 2-year history of perianal moisture,pruritus,and hematochezia,who was repeatedly misdiagnosed with mixed hemorrhoids.The diagnosis of anal canal adenocarcinoma with secondary PPD was confirmed through colonoscopy,perianal skin biopsy,and immunohistochemical staining(CK7,CK20,etc.).The patient underwent 3D laparoscopic-assisted abdominoperineal resection(APR)with extended perianal skin excision,achieving negative margins and primary wound healing.No recurrence or metastasis was observed during the 12-month follow-up.CONCLUSION Secondary PPD has a high misdiagnosis rate.Clinicians should maintain a high index of suspicion for elderly patients with prolonged perianal symptoms(e.g.,pruritus,hematochezia>6 months)and promptly perform colonoscopy and immunohistochemical testing for definitive diagnosis.APR combined with extended perianal resection is an effective treatment,and standardized long-term follow-up is crucial for prognosis.
文摘患者,男,55岁,因右鼻阻伴头痛头昏1年入院。专科检查见右侧鼻腔下鼻道中鼻道及嗅裂区可见一肿物,质地稍韧,触之易出血,边界不清,鼻窦平扫+增强CT示右侧鼻道内可见一团片影,截面3.5 cm×1.6 cm, 考虑为肿瘤性病变,遂行手术切除并做病理检查。本研究经成都市青白江区人民医院医学伦理委员审核批准(2024第15号)并经患者签署知情同意。
