Abstract
Two cases of leukoplakia of the anal canal are presented, with illustrations of the typical gross and microscopic appearance. The lesions were asymptomatic, and were discovered by routine rectal examination. Histological findings included hyperkeratosis and acanthosis extending cephalad from the anal verge to the dentate line. Followup after 3 and 15 years revealed no evidence of dysplastic changes, and a review of the literature did not uncover any reported cases with dysplasia or with documented evolution to malignancy. There is little evidence that leukoplakia of the anal canal is premalignant but patients should be followed carefully, since the natural history of this rare lesion is unknown.
Similar content being viewed by others
References
Waldron CA: Oral epithelial tumors. Thoma's Oral Pathology. R Gorlin, H Goldman (eds). Mosby, St. Louis, 1970, pp 801–860
Bender MD, Allison J, Cuartas F, et al: Glycogenic acanthosis of the esophagus: A form of benign epithelial hyperplasia. Gastroenterology 65:373–380, 1973
Bacon HE: Cancer of the Colon, Rectum, and Anal Canal. Lippincott, Philadelphia, 1964, pp 336–338
Morson BC, Dawson IMP: Gastrointestinal Pathology. Blackwell, London, 1972, pp 621–624
Remstrup G: Leukoplakia of the oral cavity. A clinical and histopathologic study. Acta Odontol Scand 16:99–111, 1958
Shklar G: The precancerous oral lesion. Oral Surg 20:58–70, 1965
Mehta F, Daftary D, Shroff M, et al: Clinical and histologic study of oral leukoplakia in relation to habits: A five year followup. Oral Surg 28:372–388, 1969
Pindborg J, Remstrup G, Jolst O, et al: Studies in oral leukoplakia: A preliminary report on the period prevalance of malignant transformation in leukoplakia based on a followup study of 248 patients. J Am Dent Assoc 76:767–771, 1968
Rosser C: The etiology of anal cancer. Am J Surg 11:328–333, 1931
Keyes EL: Squamous cell carcinoma of the lower rectum and anus. Ann Surg 106:1046–1058, 1937
Jackman R: Lesions of the Lower Bowel. Charles Thomas, Springfield, Illinois, 1958, pp 302–303
Gabriel WB: Discussion on squamous cell carcinoma of the anus and anal canal. Proc R Soc Med 53:403–409, 1960
Buie LA: Practical Proctology. Charles Thomas, Springfield, Illinois, 1960, pp 296–300
Goligher JC: Surgery of the Anus, Rectum, and Colon. Balliere, Tindall, and Cassell, London, 1967
Turell R: Diseases of the Colon and Anorectum. Saunders, Philadelphia, 1969
Sleisenger M, Fordtran J (eds): Gastrointestinal Disease. Saunders, Philadelphia, 1973
Ackerman LV, Rosai J (eds): Surgical Pathology. Mosby, St. Louis, 1974
Silverman S, Rozen R: Observations on the clinical characteristics and natural history of oral leukoplakia. J Am Dent Assoc 76:772–777, 1968
Landsman AA: Precancerous conditions about the rectum. Med J Rec 121:135–137, 1925
Buie LA, Brust JC: Malignant anal lesions of epithelial origin. J-Lancet 53:565–571, 1933
Raiford TS: Epitheliomata of the lower rectum and anus. Surg Gynecol Obstet 57:21–35, 1933
Gabriel WB: Squamous cell carcinoma of the anus and anal canal. Proc Soc Med 34:139–157, 1941
Cattell RB, Williams AC, Epidermoid carcinoma of the anus and rectum. Arch Surg 46:336–349, 1943
Buxton RW: Squamous cell anal carcinoma. Arch Surg 67:821–838, 1953
Grinnell RS: An analysis of 49 cases of squamous cell carcinoma of the anus. Surg Gynecol Obstet 98:29–39, 1954
Judd ES, DeTar BE: Squamous cell carcinoma of the anus. Surgery 37:220–228, 1955
Buckwalter J, Jurayj MN: Relationship of chronic anorectal disease to carcinoma. Arch Surg 75:352–360, 1957
Hayden EP: Medical progress—proctology. N Engl J Med 260:420–429, 1959
Richards JC, Beahrs OH, Woolner LB: Squamous cell carcinoma of the anus, anal canal, and rectum in 109 patients. Surg Gynecol Obstet 114:475–479, 1962
Dillard BM, Spratt JS, Ackerman LV, et al: Epidermoid carcinoma or the anal margin and canal. Arch Surg 86:772–776, 1963
Cabrera A, Tsukada Y, Pickren JW: Adenocarcinoma of the anal canal and perianal tissues. Ann Surg 164:152–156, 1966
Kuehn P, Eisenberg H, Reed J: Epidermoid carcinoma of the perianal skin and anal canal. Cancer 22:932–938, 1968
Wolfe HRI, Bussey HJR: Squamous cell carcinoma of the anus. Br J Surg 55:295–301, 1968
Stearns MW, Quan SH: Epidermoid carcinoma of the anorectum. Surg Gynecol Obstet 131:953–956, 1970
McConnell EM: Squamous cell carcinoma of the anus—a review of 96 cases. Br J Surg 57:89–92, 1970
Moller C, Saksela E: Cancer of the anus and anal canal. Acta Chir Scand 136:340–348, 1970
Sawyers JL: Squamous cell carcinoma of the perianus and anus. Surg Clin N Am 52:935–941, 1972
Brennan JT, Stewart CF: Epidermoid carcinoma of the anus. Ann Surg 176:787–790, 1973
O'Grady JF, Bacon HE, Kookdary A: Squamous cell carcinoma of the anus. Dis Colon Rectum 16:39–41, 1973
Grodsky L: Unsuspected anal carcinoma discovered after minor anorectal surgery. Dis Colon Rectum 10:471–478, 1967
Grodsky L: Rare nonkeratinizing malignancies of the anal region. Arch Surg 90:216–221, 1965
Helwig EB, Graham JH: Anogenital (extramammary) Paget's disease. Cancer 16:387–403, 1963
Oriel JD, Whimster IW: Carcinoma in situ associated with virus containing anal warts. Br J Dermatol 84:71–73, 1971
Morson BC, Dawson IMP: Gastrointestinal Pathology. Blackwell, London, 1972, pp 450–452
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Bender, M.D., Lechago, J. Leukoplakia of the anal canal. Digest Dis Sci 21, 867–872 (1976). https://doi.org/10.1007/BF01072079
Issue Date:
DOI: https://doi.org/10.1007/BF01072079