Abstract
A 67-year-old woman who visited a hospital because of anal bleeding in October 2009 was found to have an easily bleeding type 2 lesion at the rectum Ra about 10 cm distal from the anal verge by colonoscopy. Following biopsy, squamous cell carcinoma was diagnosed. At digital examination performed when she was first seen at our hospital, the inferior margin of the tumor was palpated at the rectum Ra about 10 cm distal from the anal verge. Abdominal CT findings were suggestive of involvement of lymph node #216. Preoperative radiation therapy was employed and a total dose of 45 Gy was irradiated. Combined with the radiation therapy, the patient was given oral administration of S-1 at a dose of 80 mg/ day for 2 weeks with a one-week withdrawal period. In February 2010 when a tumor diminishing effect was gained, low anterior resection of the rectum D3, periaortic lymph node dissection, and prophylactic ileostomy were performed. Histopathology proved no residual tumor, and the effect of the preoperative chemoradiation therapy was rated for the carcinoma as CR (grade 3), and for #216 LN, as CR (grade 3) as well.
Primary malignant neoplasms of the large intestines are predominantly adenocarcinoma. Primary squamous cell carcinoma of the rectum is extremely rare, accounting for less than 0.1%. Few reports on some established therapies for this type of malignancy have been presented so far. We report a rare case of squamous cell carcinoma of the rectum which was diagnosed from the biopsy findings, together with a review of the literature.
