Editing Anal neoplasms (section)

== '''SCC of anal     margin''' (can     visualise whole tumour without entering anal canal) ==

** Behave like skin cancers and      are staged accordingly
** Tend to be more symptomatic      - pain, itching, burning, bleeding, palpable mass, and discharge
** Typically seen as an      ulcerated lesion with rolled, everted edges
** Usually reported as well or      moderately differentiated keratinising SCC
** Distant metastases are rare      - biologically less aggressive
** Lymph node involvement is an      important adverse prognostic factor
** Bulky, advanced tumours      extending into anal canal should be treated like anal canal SCC, but if      limited to anal margin, treat like cutaneous SCC
** Excise locally with 0.5-1cm      margin. If margins are positive or close, radiotherapy can be      administered with good results.
*** If impossible to manage       like this due to local factors, consider definitive CRT or APR
**