Anal and perianal malignancies

Perianal carcinomas must be segregated from anal canal carcinomas, which occur above the anal verge. Perianal malignancies are managed as are skin malignancies elsewhere on the body. Squamous cell carcinomas of the anal canal less than 2 cm in diameter may be treated by local excision. Other epidermoid anal canal carcinomas are best treated with either radiation therapy or a combination of chemotherapy and radiation followed by abdominoperineal resection for those patients with residual tumor on biopsy.