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      Primary squamous cell carcinoma of the rectum: a case report and literature review

      case-report

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          Abstract

          Squamous cell carcinoma (SCC) of the rectum is a rare occurrence with an incidence rate of 0.1–0.25% per 1,000 cases. Herein, we report a case of a 52-year-old female who presented with a 2-month history of diffuse lower abdominal pain and hematochezia. Abdominal CT scan revealed a 7-cm irregular rectal mass, and the biopsy showed SCC.

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          Squamous carcinoma of the colorectum and its genesis.

          Sybil Williams, James A. Blackshaw, B C Morson (1979)
          A case of pure aquamous carcinoma of the rectum is presented, and the literature reviewed. Squamous carcinomas of the colorectum are rare tumours which have clinicopathological features in common with adenocarcinomas. Evidence is presented to support the proposal that most tumours of the large intestine that consist partly or completely of squamous elements arise from areas of squamous differentiation in pre-existing adenomas. The pathogenesis of squamous carcinoma and adenosquamous carcinoma appears to be similar to that of adenocarcinoma.
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            Squamous cell cancer of the rectum.

            Peter V. Draganov, T Dyson (2009)
            Squamous cell carcinoma of the rectum is a rare malignancy. It appears to be associated with chronic inflammatory conditions and infections. The clear association seen between Human Papilloma Virus and various squamous cancers has not been firmly established for the squamous cell cancer of the rectum. The presentation is nonspecific and patients tend to present with advanced stage disease. Diagnosis relies on endoscopic examination with biopsy of the lesion. Distinction from squamous cell cancer of the anus can be difficult, but can be facilitated by immunohistochemical staining for cytokeratins. Staging of the cancer with endoscopic ultrasound and computed tomography provides essential information on prognosis and can guide therapy. At present, surgery remains the main therapeutic option; however recent advances have made chemoradiation a valuable therapeutic addition. Squamous cell carcinoma of the rectum is a distinct entity and it is of crucial importance for the practicing Gastroenterologist to be thoroughly familiar with this disease. Compared to adenocarcinoma of the rectum and squamous cell cancer of the anal canal, squamous cell carcinoma of the rectum has different epidemiology, etiology, pathogenesis, and prognosis but, most importantly, requires a different therapeutic approach. This review will examine and summarize the available information regarding this disease from the perspective of the practicing gastroenterologist.
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              Squamous-cell carcinoma of the rectum: a rare but curable tumor.

              Deborah Schrag, Wayne Joseph, Larissa K. Temple … (2007)
              This study was designed to evaluate one institution's experience with treatment outcomes for rectal squamous-cell carcinoma. Using our prospective Colorectal Database, we identified patients diagnosed with rectal squamous-cell carcinoma at our institution between 1983 and 2005. Pathology was rereviewed, tumor immunophenotype was compared to control cases of anal squamous-cell carcinoma and rectal adenocarcinoma, treatment modalities and outcomes were analyzed. Twelve patients were identified (10 females median age, 58 years). Median distal extent of tumors was 7 (range, 5-8) cm from the anal verge. Treatment included chemotherapy only (n = 1), chemoradiation only (n = 2), induction chemotherapy followed by chemoradiation and surgery (n = 2), chemoradiation followed by surgery (n = 5), and surgery followed by chemoradiation (n = 2). The chemotherapy regimen was 5-fluorouracil-based. Radiotherapy total dose was 50.4 Gy (1.8 Gy/day, daily x 5) external iliac and inguinal nodes were not included in the radiation field. Complete clinical responders to chemoradiation (n = 2) received no further treatment. All seven partial responders underwent surgery; six had complete pathologic response; nodal status in two of six was unknown because they had local excision. Immunophenotypical analysis showed similar keratin expression profile between rectal squamous-cell carcinoma (n = 5) and rectal adenocarcinoma (n = 5), which is different from anal squamous-cell carcinoma (n = 10). All patients were alive without evidence of disease at follow-up (median follow-up, 2.6 (range, 0.5-16) years). Our data suggest that most patients treated with upfront chemoradiation therapy followed by surgery did well. Sphincter-preserving surgery is usually feasible. Clinical judgment of tumor response after chemoradiation is not completely reliable. Immunohistochemistry suggests a common cellular origin for rectal squamous-cell carcinoma and rectal adenocarcinoma, which is different from anal squamous-cell carcinoma.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Community Hosp Intern Med Perspect
                Journal ID (iso-abbrev): J Community Hosp Intern Med Perspect
                Journal ID (publisher-id): JCHIMP
                Title: Journal of Community Hospital Internal Medicine Perspectives
                Publisher: Co-Action Publishing
                ISSN (Electronic): 2000-9666
                Publication date (Electronic): 06 July 2016
                Publication date Collection: 2016
                Volume: 6
                Issue: 3
                Electronic Location Identifier: 10.3402/jchimp.v6.31708
                Affiliations
                [1 ]Department of Internal Medicine, Elmhurst Hospital Center, Elmhurst, NY, USA
                [2 ]Department of Gastroenterology, Elmhurst Hospital Center, Elmhurst, NY, USA
                [3 ]Department of Internal Medicine, Wyckoff Heights Medical Center, Brooklyn, NY, USA
                Author notes
                [* ]Correspondence to: Neil Vyas, Icahn School of Medicine at Mount Sinai (Elmhurst). 79-01 Broadway, Elmhurst, NY 11373, Email: Neil.vyas@ 123456mssm.edu
                Article
                Publisher ID: 31708
                DOI: 10.3402/jchimp.v6.31708
                PMC ID: 4942521
                PubMed ID: 27406458
                SO-VID: adef4ee5-53e4-4515-8608-bdf61ee97a17
                Copyright © © 2016 Neil Vyas et al.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 23 March 2016
                Date revision received : 13 June 2016
                Date accepted : 15 June 2016
                Categories
                Subject: Case Report

                Keywords: squamous cell carcinoma,scc,colorectal carcinoma
                Data availability:
                Keywords: squamous cell carcinoma, scc, colorectal carcinoma

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