Case Report: Management of rectal squamous cell carcinoma - a treatment dilemma

Abstract

Primary rectal squamous cell carcinoma is rare compared to adenocarcinoma, which is the predominant histologic type most commonly discovered at the time of colorectal carcinoma diagnosis. Due to the infrequent nature of this malignancy, data on tumor pathogenesis and risk factors remains sparse. Moreover, no standardized therapeutic regimen exists. This report describes a case of advanced rectal squamous cell carcinoma diagnosed in a 46-year-old female who initially presented with abdominal pain. Her clinical course was uncomplicated and she responded well to the selected therapy. Much work remains to be accomplished for patients with rectal squamous cell carcinoma.

Squamous Cell Rectal Carcinoma: About A Rare and Unusual Case: A Case report

“…Primary rectal squamous cell carcinoma is exceptionally rare, accounting for 0.10-0.25 per 1000 CRCs. Other histological types that can be observed in CRC are squamous cell carcinoma, neuroendocrine tumors, lymphomas, carcinoid tumors or leimyosacromas [1] . The first case of RSCC dates back to 1933 and was first reported by Raiford [3] .…”

“…While multiple theories to explain their aetiology have been developed, the most accepted ones are chronic inflammation due to inflammatory bowel infections such as Human Immunodeficiency virus (HIV), Human Papilloma virus (HPV), amebiasis, chronic mucosal injury or radiation exposure as triggers for squamous metaplasia [5] . Tobacco use has also been incriminated in the pathogenesis of the RSCC [1] . RSCC appears to affect Caucasian individuals with an average age of 60 years, and in contrast to rectal adenocarcinoma, it affects most likely women [1,6] .…”

“…Tobacco use has also been incriminated in the pathogenesis of the RSCC [1] . RSCC appears to affect Caucasian individuals with an average age of 60 years, and in contrast to rectal adenocarcinoma, it affects most likely women [1,6] .…”

“…Immunohistochemistry helps to differentiate rectal from anal lesions [8] . While this specific IHC stain was not used in our case due to its limited availability, the immunoreactivity of cytokeratin CAM5.2, an epithelial marker, suggests that the primary tumour site is the rectal tissue, rather than the anus [1] . Thus ruling out the tumor to be a proximal extension of an ASCC.…”

“…The most common histological type for colorectal cancers is adenocarcinoma accounting for 90% of colorectal cancers (CRCs), while for anal canal cancers it is squamous cell carcinoma. Primary rectal squamous cell carcinoma (RSCC) is exceedingly rare [1] . Several theories have been put forward to explain the pathophysiology of RSCC ranging from to the presence or pluripotent stem cells of the endodermal origin in the colorectal mucosa to the proliferation of basal cells into squamous cells due to damage to the colorectal mucosa [2] .…”