Synchronous Squamous Cell Carcinoma of the Anorectum and Proctosigmoid—a Case Report

Abstract

Primary squamous cell carcinoma of the rectum is extremely rare. Squamous cell carcinoma of the anorectum is a known entity evaluation and treatment protocols have been well defined. The occurrence of squamous cell carcinoma of rectosigmoid in concurrence with squamous cell carcinoma of the anal canal is extremely rare and the first case to be reported in the literature. A 48-year-old male patient presented with difficulty in passing stools. The clinical examination, colonoscopy, and the histopathology revealed synchronous proctosigmoid and the anorectal neoplasm. A case like this will pose a diagnostic challenges; squamous cell carcinoma of the rectum is not defined in the medical literature; synchronous squamous cell carcinoma will pose both diagnostic dilemmas and treatment challenges like whether to conserve the sphincter or not. Because squamous cell carcinoma of the anorectum can be treated by chemoradiotherapy, even this case is initially thought of treating by neoadjuvant chemoradiotherapy followed by low anterior resection followed by adjuvant treatment. Since there was no medical literature to support this treatment, ultimately multidisciplinary tumor board decision was made for abdominoperineal resection. Patient was treated with abdominoperineal resection and adjuvant chemoradiation. The diagnostic dilemmas and the management issues have been discussed.

Synchronous squamous cell carcinoma of rectum and anal canal- a rare entity

“…Our patient was a 78 year-old man who was a tobacco chewer, opium addict and smoker for 40 years, with none of these associated conditions. The only other case of synchronous rectal and anal SCC reported in literature was a 48 year-old man with no addictions [2].…”

“…Of all the colorectal SCC, rectum is the most common site for SCC, accounting for 93.4% cases [5]. Rectal SCC with synchronous anal SCC is a rarer entity and only one case has been reported yet [2].…”

“…Synchronous malignancy of rectum and anal canal are rare and mostly a rectal adenocarcinoma with an anal SCC. Synchronous rectal with anal SCC is extremely rare and, in our knowledge, there is only 1 case reported in English literature [2]. We present a case of synchronous SCC of rectum and anal canal and discuss the challenges faced in the management of this case.…”

Synchronous Squamous Cell Carcinoma of Rectum and Anal Canal Detected by FDG PET/CT—A Rare Entity

“…[1][2][3] Synchronous anal and rectal squamous cell carcinoma is an extremely rare entity, and only one case has been reported in English literature. 4 18 F-FDG PET/CT is useful in detecting synchronous adenocarcinomas of the appendix, colon, and rectum. 5,6 It is recommended in the metastatic evaluation of synchronous rectal malignancy and in its restaging with a rising serum carcinoembryonic antigen.…”

“…Squamous cell carcinoma is the most common malignancy of the anal canal, but it is a rare histological subtype in the rectum, accounting for only 0.3% of rectal malignancies 1–3 . Synchronous anal and rectal squamous cell carcinoma is an extremely rare entity, and only one case has been reported in English literature 4 . 18 F-FDG PET/CT is useful in detecting synchronous adenocarcinomas of the appendix, colon, and rectum 5,6 .…”