Primary squamous cell carcinoma of the colon: A rare case report

Hussein Nassar; Karim Ataya; Bassel Hafez; Ayman El Bsat; Luna Geagea; Walid Faraj

doi:10.1016/j.ijscr.2022.107383

Primary squamous cell carcinoma of the colon: A rare case report

Int J Surg Case Rep. 2022 Jul:96:107383. doi: 10.1016/j.ijscr.2022.107383. Epub 2022 Jul 5.

Authors

Hussein Nassar¹, Karim Ataya², Bassel Hafez³, Ayman El Bsat⁴, Luna Geagea⁵, Walid Faraj⁶

Affiliations

¹ Department of Hepatobiliary & Pancreatic Surgery, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom. Electronic address: h.nassar@nhs.net.
² Department of Upper GI and Bariatric Surgery, Kings College Hospital London, London, United Kingdom. Electronic address: karim.ataya@nhs.net.
³ Department of General Surgery, American University of Beirut Medical Center, Bliss Street, Beirut, Lebanon. Electronic address: bh63@aub.edu.lb.
⁴ Department of General Surgery, American University of Beirut Medical Center, Bliss Street, Beirut, Lebanon. Electronic address: Aa458@mail.aub.edu.
⁵ Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Bliss Street, Beirut, Lebanon. Electronic address: Lg19@mail.aub.edu.
⁶ Department of General Surgery, American University of Beirut Medical Center, Bliss Street, Beirut, Lebanon. Electronic address: Wf07@aub.edu.lb.

Abstract

Introduction and importance: Squamous cell carcinoma (SCC) of the colon is an extremely rare pathologic entity, accounting for less than 1 % of all colorectal cancer cases. They tend to be very aggressive with poor outcomes and treatment strategies are still controversial due to the paucity of data available to guide management.

Case presentation: A case of a cecal mass with metastatic liver lesions. Initially diagnosed as an adenocarcinoma, the patient underwent resection with metastasectomy. Despite achieving negative surgical margins and undergoing adjuvant chemotherapy, the patient relapsed and presented with a new mass in the descending colon. The patient underwent resection with subsequent follow-up revealing distant metastasis. The patient passed away soon after.

Clinical discussion: Primary colorectal SCC has similar presentation to adenocarcinoma of the colon. Unfortunately, it usually presents at a late stage. Diagnosis of colorectal SCC requires histologic confirmation of SCC plus exclusion of possible causes. Management is predominantly definitive radical resection followed by adjuvant chemotherapy and radiotherapy. Surgical margins should be at least 5 cm, preferably 10 cm. Lymph node yield greater than 20 was associated with improved survival. Studies assessing the prognosis of primary colorectal SCC following chemo-radiotherapy have not been done.

Conclusion: Surgery remains the most vital important step in the management of colonic SCC. The role of chemotherapy and/or radiation remains questionable. Depending on the aggressiveness of this disease the need for further frequent.

Keywords: Colon; Primary; Squamous cell carcinoma; Therapeutic.