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A 38-year-old homosexual male presented to our hospital with a two-week history of foreign body and itching sensation in the anus. There were no changes in his appetite and body weight. In his medical history, there is no gastroduodenal ulcer or hematochezia. He was afebrile on admission, and physical examination of abdomen showed no palpable mass or tenderness. There were no palpable inguinal lymph nodes. Laboratory data showed no remarking findings and negative human immunodeficiency virus (HIV). Tumor markers revealed normal carcinoembryonic antigen (CEA) and carbohydrate antigen-199 (CA-199) levels. Digital examination showed multiple exophytic lesions over the anal canal. Anoscopy showed verrucous papules at the anorectal junction and all lesions in clusters of two or three were less than 1 cm in diameter. Excisional biopsy was performed. Histopathologic report indicated a diagnosis of co-existing condyloma acuminata and poorly-differentiated adenocarcinoma of the anal canal without stromal invasion (Fig. 1). In addition, the epithelium showed vacuolization or koilocytosis, characteristic of human papillomavirus (HPV) infection. Colonscopy was performed without abnormal findings and the patient underwent wide excision. The postoperative course was unevenful, and the patient was discharged on the 4 postoperative day. He recovered well without further recurrence of anal cancer or condyloma acuminata at 12 months follow-up.

Not only aondyloma acuminata of the anal canal: a rare case with coexisting adenocarcinoma