Z Gastroenterol 2018; 56(05): 495-498
DOI: 10.1055/a-0578-9059
Kasuistik
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic submucosal dissection (ESD) for anal high-grade intraepithelial neoplasia: a case report

Endoskopische Submukosadissektion (ESD) für hochgradige anale intraepitheliale Neoplasie: ein Fallbericht
Andrej Wagner
1   Department of Internal Medicine I, Paracelsus Medical University/Salzburger Landeskliniken (SALK), Salzburg, Austria
,
Daniel Neureiter
2   Institute of Pathology, Paracelsus Medical University/Salzburger Landeskliniken (SALK), Salzburg, Austria
,
Josef Holzinger
3   Department of Surgery, Paracelsus Medical University/Salzburger Landeskliniken (SALK), Salzburg, Austria
,
Tobias Kiesslich
4   Laboratory for Tumour Biology and Experimental Therapies (TREAT), Institute of Physiology and Pathophysiology, Paracelsus Medical University, Salzburg, Austria
,
Eckhard Klieser
2   Institute of Pathology, Paracelsus Medical University/Salzburger Landeskliniken (SALK), Salzburg, Austria
,
Frieder Berr
1   Department of Internal Medicine I, Paracelsus Medical University/Salzburger Landeskliniken (SALK), Salzburg, Austria
› Author Affiliations
Further Information

Publication History

10 November 2017

06 February 2018

Publication Date:
07 May 2018 (online)

Abstract

Anal intraepithelial neoplasia (AIN) is a precursor of anal carcinoma. Conventional therapy is based on topical and local ablative approaches. However, the recurrence rates are very high, leading to repetitive treatment sessions and need for long-term surveillance. Endoscopic submucosal dissection (ESD) is an established treatment for malignant early neoplasias of the gastrointestinal tract, especially in the esophagus, stomach, and colorectum. Japanese centers have reported few cases of ESD for early anal carcinoma. We report a case of high-grade AIN diagnosed with magnifying narrow-band imaging and chromoendoscopy that was resected R0 with ESD en bloc.

Zusammenfassung

Die anale intraepitheliale Neoplasie (AIN) ist die Vorläuferläsion des Analkarzinoms. Bisherige Therapieoptionen beschränkten sich auf topische und ablative Verfahren, denen eine sehr hohe Rezidivrate gemeinsam ist. Dies macht engmaschige Verlaufsuntersuchungen und Nachbehandlungen erforderlich. Die Endoskopische Submukosadissektion (ESD) hat sich als Therapie von malignitätsverdächtigen Frühneoplasien des Gastrointestinaltraktes im Ösophagus, Magen und Kolon etabliert. Zur ESD von analen Frühkarzinomen liegen nur einzelne Fallberichte aus japanischen Zentren vor. Der vorliegende Fallbericht stellt die R0 Resektion einer hochgradigen AIN mittels en-bloc ESD nach umfassender Diagnostik mit hochauflösender Videoendoskopie vor.

 
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