In all cases, the tumors were mucinous adenocarcinomas with minimal cytologic atypia. Of the 4 patients, one is dead, and we have lost the follow-up of another one 13 months after surgery when he had no evidence of recurrence. In every patient with a long-standing anal fistula or a recurrent anal abscess, a biopsy is mandatory to rule out an underlying low grade mucinous carcinoma and if it shows a low grade mucinous adenocarcinoma, the treatment of choice will be local resection if it is available. If not, an abdominal perineal resection showed be done without hesitation. Anal cancer is very rare, but its diagnosis is often too late.
Treatment is usually non surgical and can be very effective.
Prognosis can be improved by earlier diagnosis. Proctoscopy is mandatory for all symptomatic patients. Could an high risk population be determined, the incidence of anal cancer could fall. By contrast, rectal cancer is one of the most frequent and its prognosis has not been improved. Apropos of 5 cases.