CASE-REPORT OF PRIMARY SQUAMOUS CARCINOMA OF THE RECTUM

Purpose. To report a patient with primary squamous carcinoma of the re ctum. Case report. A 40-year-old woman with hematochezia and change in bower habits was studied. The main laboratory finding was a mild anem ia. A barium enema and a proctoscopy revealed a rectal neoplasm at eig ht cm from the anal verge. A transendoscopic biopsy demonstrated an sq uamous rectal carcinoma. A transrectal ultrasound and CT scan of the a bdomen revealed a big rectal mass with transmural affection and possib le involvement of the lymph nodes. The carcinoembriogenic antigen (CEA ) was high (32 ng/mL). The patient underwent radiotherapy with 46 Gy, and 5-fluorouracil as radiosensitizer. Three months later, a new CT sc an showed significant reduction of the size of the mass, and the patie nt underwent a very low anterior resection with double-stapled anastom osis. The analysis of the specimen showed a squamous carcinoma of the mid-rectum, invading through the wall without lymph node affection and with proximal, distal, and radial margins free of tumor. The CEA retu rned to normal after surgery (1.3 ng/mL). The patients is alive and wi thout evidence of disease 18 months after the operation. Conclusion. P rimary squamous carcinoma of the rectum is a rare disease, and surgery seems to be a good option of treatment, with the possibility of sphin cter preservation depending upon the location of the tumor.