Published online Jul 26, 2020. doi: 10.12998/wjcc.v8.i14.3057
Peer-review started: April 1, 2020
First decision: April 24, 2020
Revised: April 30, 2020
Accepted: July 14, 2020
Article in press: July 14, 2020
Published online: July 26, 2020
Processing time: 113 Days and 4.2 Hours
Compared with colorectal adenocarcinoma, basaloid squamous cell carcinomas (BSCCs) arising in the colorectum are rare and have very poor prognosis. To date, only nine cases have been reported. Most BSCCs are extensively involved in metastasis to the lymph node, liver, and lung at diagnosis. Despite many clinicians attempting to effectively treat BSCCs, therapeutic consensus has not been established due to lack of information.
A 58-year-old woman presented with abdominal pain, diarrhea, fever, and hematochezia. She was referred from a department of gynecology and was diagnosed with a suspicious leiomyosarcoma of the rectum or a pedunculated myoma of the uterus. An exophytic growing mass at the right lateral wall of the rectum with an internal cystic portion and hemorrhage was observed on magnetic resonance imaging. The patient underwent low anterior resection and total hysterectomy with bilateral salphingo-oophorectomy. Histopathological findings revealed a cellular mass with a solid growth pattern and few glandular structures, many foci of intratumoral necrosis, and a palisading pattern. The pathologist diagnosed tumor as a BSCC, and the patient received chemotherapy with fluorouracil/leucovorin without radiotherapy. The patient is currently alive 8 years after the surgery with no manifestations of metastatic colon cancer.
Our case suggest that curative resection and chemotherapy play important roles in improving survival, and radiotherapy may be an option to avoid radiation-associated enteritis.
Core tip: Basaloid squamous cell carcinoma in the colorectum is extremely rare and has poor prognosis. Here, we present a rare case of the successful treatment of basaloid squamous cell carcinoma in the rectosigmoid colon. The patient with this rare tumor has the longest survival, and thus, curative resection and chemotherapy may play important roles in improving survival. To avoid radiation-associated enteritis, postoperative radiotherapy may be an option.