Efficacy of prostatectomy using a Retzius-sparing approach as an additional excision in anal canal carcinoma after brachytherapy for prostate adenocarcinoma

Introduction

Standard treatments for squamous cell carcinoma of the anal canal include chemoradiotherapy and surgical resection. We report a rare case of squamous cell carcinoma of the anal canal with prostate invasion treated with curative surgical methods using a Retzius-sparing robot-assisted approach.

Case presentation

A 76-year-old male had undergone brachytherapy for prostate adenocarcinoma (cT2aN0M0). Nine years later, the patient was diagnosed with anal canal carcinoma (cT2N0M0) following the onset of anal pain. During a robot-assisted abdominoperineal resection, prostate invasion was suspected and a prostatectomy was performed as an additional excision of the prostate using a Retzius-sparing approach. Although an anastomotic leak was observed postoperatively, it was conservatively managed with bilateral ureteral stent placement. The patient remained recurrence-free after surgery.

Conclusion

A Retzius-sparing robot-assisted approach in radical prostatectomy may be a safe and feasible option for cases of anal canal carcinoma with suspected prostate invasion.