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Squamous Carcinoma of Anus
Etiology

Squamous carcinoma of the anus has been associated with a variety of sexually transmitted diseases including: HPV, Lymphogranuloma venereum, Herpes simplex, Chlamydia and Gonorrhea.
Many cases do not have evidence of a sexually transmitted disease and the etiology in these cases is unknown.
Pathogenesis

Development of carcinoma in HPV+ patients has been linked to the development of anal condyloma and intraepithelial dysplasia associated with HPV 16 and 18, similar to the develoment of cervical neoplasia in HPV+ patients.
The mode of pathogenesis in HPV- patients is unknown.,
Epidemiology

Squamous carcinoma of the anus is most common during the 5th and 6th decades.
Females are affected 2-3X more than males and whites more than blacks.
Single males have a six-fold higher incidence than married males, and this appears due to the high prevalence of HPV infection associated with anal intercourse.
There is a recent significant rise in the incidence of anal squamous carcinoma associated with the rise in HPV infection.
An increased incidence has also been noted in renal transplant patients with immunosuppression.
General Gross Description

The tumors present as mass lesions which are exophytic with a smooth surface which may be ulcerated in larger lesions.
They are present above and below the Dentate Line.
Cut surface is firm and white.
Some tumors may show evidence of contiguous condyloma in the HPV+ patients.
•Examples:
Squamous Cell Carcinoma of Anus
General Microscopic Description

The microscopic appearance is variable as several variants exist.
Most commonly their appearance is similar to non-keratinizing cervical squamous carcinoma.
The most commonly seen variants demonstrate basaloid, adenoid cystic or transitional (cloacogenic) patterns.
•Examples:
References
Grastrointestinal Pathology, Fenoglio-Preiser CM et al, New York: Raven Press 1989, pp. 826-32.

For Most Current Information Search Medline at National Library of Medicine
This link will directly take you to the relevant new literature
Squamous Carcinoma of Anus
Synopsis by: Martin Nadel M.D. (T69000M80703)[335]
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