一穴肛原癌1例附文献复习  

A case of cloacogenic carcinoma at one point with literature review

作　　者：黎宁 王欣[2] 魏明[1] 王园园[1] 姜霞[1] 李中信 LI Ning;WANG Xin;WEI Ming;WANG Yuanyuan;JIANG Xia;LI Zhongxin(Department of Gastrointestinal Surgery,the First Hospital of Hebei Medical University,Hebei Province,Shijiazhuang050000,China;Department of Pathology,the First Hospital of Hebei Medical University,Hebei Province,Shijiazhuang050000,China)

机构地区：[1]河北医科大学第一医院胃肠外科,河北石家庄050000 [2]河北医科大学第一医院病理科,河北石家庄050000

出　　处：《中国医药导报》2023年第29期186-189,共4页China Medical Herald

基　　金：河北省医学科学研究课题计划项目(20201189)。

摘　　要：一穴肛原癌是一种罕见的肛管恶性肿瘤,起源于胚胎一穴肛残余。该肿瘤存在显著的组织学异质性,可表现为移行细胞样癌、基底样鳞状细胞癌和腺样囊性癌等多种组织学类型,临床极易误诊。本文回顾性分析河北医科大学第一医院于2022年3月收治的1例一穴肛原癌患者,主要表现为肛门坠胀感、便血、大便次数增多等症状,内镜下直肠近肛缘处可见肿块型新生物,可见肿瘤血管生成。术前活检病理提示为低分化腺癌,术后病理结果为一穴肛原癌。人乳头瘤病毒检测结果阳性,宫颈检查未见异常。术后行放射治疗(DT6000c Gy/30f)。随访6个月,患者无肿瘤复发征象。本病例术前误诊为低分化腺癌,与临床医生缺乏对该疾病的认知有关。本文从组织病理学特点、临床表现、发病机制及目前的诊疗进展等方面进行文献复习,以期提高对本病的认识。Cloacogenic carcinoma is a rare malignant tumor of the anal canal,originating from the embryonic persistent cloaca remnant.This tumor has significant histological heterogeneity and can be manifested as a variety of histological types such as transitional cell carcinoma,basal-like squamous cell carcinoma,and adenoid cystic carcinoma,which is easy to be misdiagnosed clinically.In this paper,a case of cloacogenic carcinoma patient admitted to the First Hospital of Hebei Medical University in March 2022 was retrospectively analyzed,the main symptoms were anal distension,blood in stool,and increased frequency of stool and other symptoms,a neoplasms of mass type was seen near the anal margin of the rectum under endoscopy,and tumor angiogenesis was observed.The preoperative biopsy pathology showed low differentiation adenocarcinoma,and the postoperative pathological results showed cloacogenic carcinoma.The human papilloma virus test was positive,and the cervical examination showed no abnormalities.Postoperative radiotherapy(DT6000cGy/30f)was performed.After six months of follow-up,the patient had no signs of tumor recurrence.This case was misdiagnosed as poorly differentiated adenocarcinoma before surgery,which is related to the lack of recognition of the disease by clinicians.In order to improve the understanding of the disease,this article reviewed the literature from histopathological features,clinical manifestations,pathogenesis,and current progress of diagnosis and treatment.

关 键 词：一穴肛原癌 诊断 治疗 

分 类 号：R735.3[医药卫生—肿瘤]