Rectal cancer with pelvic abscess treated by preoperative chemoradiation therapy —report of a case—

Abstract

We report a case of rectal cancer with pelvic abscess treated with preoperative chemoradiation therapy.
A 63-year-old man was referred to our hospital because of fever and anal pain. We diagnosed the patient as having advanced rectal cancer with pelvic abscess. After making ileostomy for fecal diversion, we carried out chemoradiation therapy (radiotherapy at a total dose of 40 Gy over 4 weeks and chemotherapy with 5-FU+CDDP during the first week of radiotherapy). The patient tolerated chemoradiation therapy without any adverse effects and relapse of intra-pelvic infection. Colonoscopy prior to radical operation revealed a shrinkage of the tumor. He underwent sphincter-preserving surgery 6 weeks after completion of the chemoradiation therapy, followed by adjuvant chemotherapy (5-FU+LV+oxaliplatin). He has had no recurrence for 12 months after the surgery. Rectal cancer with pelvic abscess entails a high risk of developing local recurrence and hence preoperative chemoradiation therapy is meaningful. Ileostomy prior to chemoradiotherapy was helpful to cure intrapelvic abscess and prevent from its relapse.