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Squamous Cell Carcinoma of Rectum

Rectal Squamous Cell Carcinoma


Presentation

  • In the present study a case of a metastatic pure SCC of the rectum to the liver is presented.[wjso.biomedcentral.com]
  • Here we report an uncommon presentation of rectal squamous cell carcinoma in a woman on long-term immunosuppressive therapy. Actions (Repository Staff Only) Item Control Page[researchonline.jcu.edu.au]
  • The most common presenting symptoms of rectal leiomyosarcoma are hematochezia and perianal pain [ 4 ].[academic.oup.com]
  • We present a unique case report of interval SCC of the rectum in a patient who had no prior precancerous lesion on index high-quality screening colonoscopy.[karger.com]
  • Herein, we report a case of an 82-year-old female who presented with a 2-month history of worsening abdominal pain, hematochezia, and bilateral inguinal lymphadenopathy with right-sided purulent discharge.[ingentaconnect.com]
Constitutional Symptom
  • She denies constitutional symptoms including fever, weight loss, fatigue and night sweats. Additionally, she denies abdominal pain, nausea, vomiting or melena. Her social history includes a 30-pack year smoking history as well as alcohol dependence.[academic.oup.com]
Soft Tissue Mass
  • Axial and sagittal images demonstrate intense uptake (SUVmax 17.4) localising to a rectal soft tissue mass.[ecancer.org]
Abdominal Tenderness
  • Physical examination revealed diffuse lower abdominal tenderness and a rectal mass. Vital signs were stable, and laboratory results were within normal limits, with hemoglobin of 13.1 g/dL.[karger.com]
Pelvic Mass
  • Treatment to the pelvis was sequentially followed by a boost to the pelvic mass to a dose of 1000 cGy in five fractions using a 3D-conformal anterior-posterior field set-up with a 16 MV photon beam.[ecancer.org]
Night Sweats
  • She denies constitutional symptoms including fever, weight loss, fatigue and night sweats. Additionally, she denies abdominal pain, nausea, vomiting or melena. Her social history includes a 30-pack year smoking history as well as alcohol dependence.[academic.oup.com]
  • In addition to the pelvic pain, she was experiencing fatigue but there were no neurologic signs, no weight loss, fevers, or night sweats.[ecancer.org]
Osteopenia
  • Past medical history includes gastroenteritis, low back pain and osteopenia. Digital rectal exam demonstrates a fungating, anteriorly fixed, firm mass in the 12 o’clock position. Tissue was friable and gross blood was observed on a gloved finger.[academic.oup.com]

Workup

  • A preoperative workup showed localized disease with absence of metastatic disease. PATHOLOGY SLIDE OF FIGURE 2. A picture of the pathology of the mass at the ileostomy. click to enlarge PATHOLOGY SLIDE OF FIGURE 2 B.[abdominalsurg.org]
  • Further workup with colonoscopy and biopsies confirmed an unusual basaloid SCC of the rectum approximately 5 cm above the anal verge with positive p16 expression, a surrogate marker for HPV status.[ecancer.org]
  • The image below depicts the staging and workup of rectal cancer. Diagnostics. Staging and workup of rectal cancer patients. Signs and symptoms Bleeding is the most common symptom of rectal cancer, occurring in 60% of patients.[emedicine.medscape.com]
Entamoeba Histolytica
  • While risk factors have not been clearly defined, SCC of the rectum has been associated with inflammatory processes such as ulcerative colitis, Entamoeba histolytica, schistosomiasis, and human papilloma virus, which has a strong association with squamous[karger.com]
  • In addition, several cases have been reported in patients with ulcerative colitis [ 12 - 15 ] and in patients with infections including Schistosomiasis [ 16 ] and Entamoeba histolytica [ 17 ].[surgicalcasereports.springeropen.com]
  • Interrelation with the HPV infection has not been demonstrated (9) although it has been associated with another type of infections as the colitis by Entamoeba histolytica or schistosomiasis (4).[scielo.isciii.es]
Liver Biopsy
  • A liver biopsy was also obtained given her history of alcohol dependence and possible metastatic spread.[academic.oup.com]

Treatment

  • Pathology was rereviewed, tumor immunophenotype was compared to control cases of anal squamous-cell carcinoma and rectal adenocarcinoma, treatment modalities and outcomes were analyzed.[synapse.mskcc.org]
  • Given its rarity, optimal treatment is not well delineated.[ecancer.org]
  • The cytokeratin CAM 5.2 typically stains rectal SCC and not anal SCC. [4] Various treatment modalities have been tried for SCC rectum. Historically, surgery has been the primary treatment for SCC rectum.[cancerjournal.net]
  • It addresses epidemiology, biology, screening and chemoprevention, the role of imaging in diagnosis, staging and prognosis, radiation therapy, medical and surgical treatment, as well as new modalities of therapy, including laparoscopy, and transanal endoscopic[books.google.com]

Prognosis

  • […] survival and prognosis.[wjso.biomedcentral.com]
  • It addresses epidemiology, biology, screening and chemoprevention, the role of imaging in diagnosis, staging and prognosis, radiation therapy, medical and surgical treatment, as well as new modalities of therapy, including laparoscopy, and transanal endoscopic[books.google.com]
  • Due to the infrequent occurrence of leiomyosarcoma of the rectum, little is known about the epidemiology, behavior, oncological treatment and prognosis.[academic.oup.com]
  • This tumor is a distinct entity that should be carefully distinguished from basal cell carcinomas of the anal canal, which is a condition that has a very good prognosis, and anal or perianal squamous cell carcinomas, which have a different path of spread[e-ce.org]
  • Chemotherapy also helps in improvement of the prognosis.[jmedicalcasereports.biomedcentral.com]

Etiology

  • Author information 1 Department of Surgery, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan. a-matsu@nms.ac.jp Abstract Primary squamous cell carcinoma (SCC) of the colorectum is a rare malignancy of unknown etiology and pathogenesis.[ncbi.nlm.nih.gov]
  • Though its etiology and pathogenesis remains unclear, it has been associated with chronic inflammation and infections.[ingentaconnect.com]
  • Certain cancers such as those of the lung and cervix 4 are particularly prevalent after squamous cell carcinoma (SCC) of the anus and reflect shared etiologies such as smoking and human papilloma virus (HPV) infection; however, risk of developing a subsequent[o-wm.com]
  • (Etiology) Untreated (or delayed treatment of) squamous cell carcinoma in situ can result in invasive squamous cell carcinoma.[dovemed.com]

Epidemiology

  • It addresses epidemiology, biology, screening and chemoprevention, the role of imaging in diagnosis, staging and prognosis, radiation therapy, medical and surgical treatment, as well as new modalities of therapy, including laparoscopy, and transanal endoscopic[books.google.com]
  • With only 300 cases in literature, additional studies are necessary to define the epidemiology and course of leiomyosarcoma of the rectum.[academic.oup.com]
  • References Giovannucci E, Wu K: Cancers of the colon and rectum; in Schottenfeld D, Fraumeni JF Jr (eds): Cancer Epidemiology and Prevention, 3rd ed. New York, Oxford University Press, 2006. Dyson T, Draganov PV: Squamous cell cancer of the rectum.[karger.com]
  • Molecular virology and epidemiology of human papillomavirus and cervical cancer. Cancer Epidemiology 1995; 4: 415-28. 15. Edwards S, Carne C. Oral sex and the trsmission of viral STIs. Sex Transm Infect 1998; 74: 6-10. 16.[conganat.org]
  • The incidence and epidemiology, etiology, pathogenesis, and screening recommendations are common to both colon cancer and rectal cancer. The image below depicts the staging and workup of rectal cancer. Diagnostics.[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • Almost four different pathophysiological theories regarding the origin of squamous cell carcinoma of the colorectum have been proposed in the literature so far.[jmedicalcasereports.biomedcentral.com]
  • Univariate sub-group analyses showed that the treatment effect for surgery alone vs preoperative radiotherapy plus surgery was not significant in patients whose cancer (TNM stage I to IV) was located between 10.1 cm and 15 cm from the anal verge. [5] Pathophysiology[emedicine.medscape.com]

Prevention

  • We believe that more multicentric studies are needed to develop a screening tool for the prevention of SCC of the colon. Statement of Ethics The authors have no ethical disclosures. Disclosure Statement There are no conflicts of interest.[karger.com]
  • Preventive Services Task Force. Available online at . Accessed 6/16/15. Moyer, VA on behalf of the U.S. Preventive Services Task Force. (2012 June 19). Screening for Cervical Cancer: U.S. Preventive Services Task Force Recommendation Statement.[labtestsonline.it]
  • PMID 666378. " " Gardasil, Merck's Cervical Cancer Vaccine, Demonstrated Efficacy in Preventing HPV-Related Disease in Males in Phase III Study: Pivotal Study Evaluating Efficacy of Gardasil in Males in Preventing HPV 6, 11, 16 and 18-Related External[en.wikipedia.org]
  • By far, the most important factor in preventing anal cancer is preventing infection with HPV. Vaccinations to prevent HPV are available. HPV vaccination is recommended for all boys and girls and is usually given between the ages of 11-12.[oncolink.org]

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