A rare case of male pelvic squamous cell carcinoma of unknown primary origin presenting as perineal abscess and urethral stenosis

Creta, Massimiliano; Mirone, Vincenzo; Meo, S. Di; Buonopane, R.; Longo, Nicola; Fusco, Ferdinando; Forte, Nicola; Imperatore, Vittorio

doi:10.4081/aiua.2017.2.154

Cited by 6 publications

(12 citation statements)

References 2 publications

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“…The authors reported each 1 case of SCC associated with abscess or fistula (Chandramohan et al 2010 ; Jamieson and Goode 1982 ; Seya et al 2007 ; Moore et al 2016 ; Creta et al 2017 ; Garg et al 2018 ; Mizusawa et al 2019 ). In the majority of the cases, the patients were male (5/7), only 1 was female, and in 1 case, the sex was not reported.…”

Section: Discussionmentioning

confidence: 99%

Non-mucinous adenocarcinomas and squamous cell carcinomas of the anal region masquerading as abscess or fistula: a retrospective analysis and systematic review of literature

Tekbaş

Mothes

Settmacher

et al. 2021

J Cancer Res Clin Oncol

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Purpose Abscess or fistula of the anal region is an uncommon presentation of malignancy. Under the assumption of a benign condition, diagnostics is often delayed, resulting in advanced tumour stages at first diagnosis. Due to the case rarity, treatment guidelines for cancers of anorectal region masquerading as abscess or fistula are missing. Methods We analysed all patients presenting with an abscess or fistula of the anal region in our department between January 2004 and August 2020. The malignancies were included to our study to acquire data on clinical presentation, treatment and outcome. Furthermore, a systematic review to present adenocarcinomas and squamous cell carcinomas associated to an abscess or fistula was performed. Results 0.5% of the patients treated for an abscess or fistula of the anal region met the selection criteria. Mean time from the onset of symptoms to diagnosis of malignancy was 100 days. Histology revealed adenocarcinoma and squamous cell carcinoma each in two patients. All patients had locally advanced tumours without distant metastases, in two cases with regional lymph-node metastases. Neoadjuvant chemoradiation was applied in two patients. All patients underwent abdomino-perineal resection of the rectum. The overall outcome reveals a recurrence-free survival of 4.5 and 3 years for two patients. Further two patients died within 5 months after the primary resection. Conclusion Advanced carcinomas of the anorectal region may masquerade as abscess or fistula, cause diagnostic problems and delay oncologic treatment. However, even in these very advanced situations, surgical therapy with curative intent should be attempted.

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Section: Discussionmentioning

confidence: 99%

Non-mucinous adenocarcinomas and squamous cell carcinomas of the anal region masquerading as abscess or fistula: a retrospective analysis and systematic review of literature

Tekbaş

Mothes

Settmacher

et al. 2021

J Cancer Res Clin Oncol

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“…The uniqueness of this case is supported by the lack of published case reports describing men patients with this malignancy treated surgically. The two cases previously described were treated (Figure 13), one of them with chemo-radiotherapy and the other with palliative treatment given the advanced state of the disease [1,4]. From the published literature regarding squamous cell CUP in the pelvic region, the patients described were all women [1].…”

Section: Discussionmentioning

confidence: 99%

“…Within them, squamous carcinoma of unknown primary origin represents between 5-10% and are more frequent in the head and neck region, although they are also described at the uterine level and in iliac lymph nodes [1]. The presence of this type of tumors in the pelvic cavity is very rare and the majority of cases described have occurred in women, there are only two cases reported in the literature of perineal carcinoma of unknown origin in men [1,4].…”

Section: Discussionmentioning

confidence: 99%

“…Transperineal biopsy proved to be a valid option for histological diagnosis. In experienced hands, the transperineal route allows access to the small pelvis in complex situations [4]. Based on the limited literature data, it appears that squamous CUP outside of the head and neck region have a more favourable prognosis compared to other CUP and that these malignancies may respond well to a combination of surgical resection, when feasible, local radiotherapy, and platinum-based systemic chemotherapy [1].…”

Section: Discussionmentioning

confidence: 99%

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A Challenging Surgical and Reconstructive Approach to Locally Advanced Squamous Perineal Carcinoma: A Case Report and Literature Review

Palacios¹,

Poblador²,

Vegas³

et al. 2021

SCR

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Perineal carcinoma of unknown primary origin (CUP) is a rare entity and represents a diagnostic and therapeutic challenge. These tumors may respond well to a combination of surgical resection, when feasible, local radiotherapy, and platinum-based systemic chemotherapy. A 67-year-old male patient consulted for urinary discomfort associated with perineal abscess. The perineal abscess was drained, and the patient was diagnosed with perineal carcinoma of unknown origin. Computed tomography (CT) scan shows a large perineal mass that involves both corpora cavernosa and corpus spongiosum. CT and bone scan excluded the metastatic spread of the disease. Inguinal lymph nodes were not identified. The surgical treatment consisted of two different phases. Phase I: the perineal mass exeresis with total penectomy. Phase II: perineal neourethrostomy with double oral mucosa graft. Coverage of the perineal defect and morphological reconstruction of the penis with fasciocutaneous and gracilis flap. The surgical intervention lasted for nine hours and the estimated blood loss was 500cc. The patient was discharged twelve days after the intervention. Later he received adjuvant treatment with immunotherapy (Cemiplimab) because was not subsidiary to treatment with platinum for renal failure. The patient died after nine months of follow-up due to pulmonary and abdominal metastatic spread.

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“…To our knowledge, we described the second case of pelvic PGL arising from the pelvis sidewall. MRI represents an optimal diagnostic modality in cases of uncommon pelvic retroperitoneal masses in adults thanks to the multiplanar capability and the high-resolution imaging thus permitting better tumor localization and internal characterization (3)(4)(5). Moreover, MRI provides useful data to plan surgical resection (3).…”

Section: Discussionmentioning

confidence: 99%

Incidentally discovered pelvic paraganglioma: A case report

Imperatore

Creta

Meo

et al. 2017

Arch Ital Urol Androl

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Paragangliomas (PGL) are rare neuroendocrine tumors of the autonomic nervous system originating from paraganglia. Although PGL may arise at any site where physiologic paraganglionic tissue exists, the localization in the small pelvis is extremely rare. PGL may be hormonally active and release surplus catecholamines into the blood or inactive. The asymptomatic cases pose a diagnostic dilemma. We describe the case of an asymptomatic PGL arising in the small pelvis sidewall presenting as an incidentally discovered asymptomatic mass in a male subject. KEY WORDS: Magnetic Resonance Imaging; Paraganglioma. lesion at the level of the left paravesical space on abdominal ultrasound imaging. His past medical history was relevant for simple prostatectomy performed 1 year before. His Prostate Specific Antigen value was 2.9 ng/dL. Physical examination including digital rectal examination was unremarkable. His arterial blood pressure and heart rate were within the normal ranges. He denied systemic symptoms, lower urinary tract symptoms, pain, and hematuria. A computed tomography of the abdomen revealed the presence of a 38 mm nodular mass located at the level of the left obturator space characterized by internal inhomogeneity and an intense peripheral enhancement in the portal phase with rapid washout. No significant abnormalities of other abdominal organs were detected. A Magnetic Resonance Imaging (MRI) with contrast medium of the pelvis confirmed the presence of an inhomogeneous 38 x 35 mm extraperitoneal mass located into the left obturator space in the proximity of the vesicoprostatic junction characterized by an intense contrast enhancement in the arterial phase and expansive growth pattern (Figure 1). Although suggestive of probable benign disease, radiological findings were inconclusive, and an exploratory laparotomy with excision of mass was planned. The procedure was technically challenging due to the adherence of the mass to the vascular structures of the

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A rare case of male pelvic squamous cell carcinoma of unknown primary origin presenting as perineal abscess and urethral stenosis

Cited by 6 publications

References 2 publications

Non-mucinous adenocarcinomas and squamous cell carcinomas of the anal region masquerading as abscess or fistula: a retrospective analysis and systematic review of literature

Non-mucinous adenocarcinomas and squamous cell carcinomas of the anal region masquerading as abscess or fistula: a retrospective analysis and systematic review of literature

A Challenging Surgical and Reconstructive Approach to Locally Advanced Squamous Perineal Carcinoma: A Case Report and Literature Review

Incidentally discovered pelvic paraganglioma: A case report

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