Abstract

Pelvic squamous cell carcinoma of unknown primary origin has been described in several case reports of female patients. However, there have been no published reports describing male patients with pelvic squamous cell cancer of unknown primary origin. Our case describes a 52-year-old man who presented with right buttock pain, rectal urgency, and constipation. His physical examination demonstrated tenderness to palpation around his gluteal folds. Computed tomography scan of his abdomen and pelvis demonstrated a large mass in his retroperitoneum. The mass was determined to be squamous cell carcinoma of unknown primary origin. Additionally, the patient had small nodules in his right lower lung lobe and right hepatic lobe. The patient was treated with concomitant chemoradiation, including cisplatin and intensity-modulated radiation therapy, followed by carboplatin and paclitaxel. The patient achieved partial remission, in which he remained one year after his presentation. Our case is consistent with the literature which suggests that squamous cell carcinoma of unknown primary origin occurring outside of the head and neck region may have a more favorable prognosis than other carcinomas of unknown primary origin. Further studies are necessary to determine the most appropriate work-up, diagnosis, and optimal treatment strategies.

Highlights

  • Carcinomas of unknown primary (CUP) origin account for 3–5% of all malignancies and can be defined as “a heterogeneous group of metastatic tumors for which a standardized diagnostic work-up fails to identify the site of origin at the time of diagnosis” [1]

  • Metastatic squamous cell CUP occurring in the pelvic cavity is extremely rare, with several case reports described involving female patients

  • These cases include a patient presenting with iliac lymph node metastases and a patient with an incidental pelvic mass found upon work-up for dysfunctional uterine bleeding [3, 4]

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Summary

Introduction

Carcinomas of unknown primary (CUP) origin account for 3–5% of all malignancies and can be defined as “a heterogeneous group of metastatic tumors for which a standardized diagnostic work-up fails to identify the site of origin at the time of diagnosis” [1]. Among CUPs, squamous cell carcinoma accounts for 5–10%, often presenting in the cervical, supraclavicular, and inguinal lymph nodes [2]. Metastatic squamous cell CUP occurring in the pelvic cavity is extremely rare, with several case reports described involving female patients. These cases include a patient presenting with iliac lymph node metastases and a patient with an incidental pelvic mass found upon work-up for dysfunctional uterine bleeding [3, 4]. There have been no published reports describing male patients with pelvic squamous cell CUP. We describe a case of metastatic squamous cell CUP occurring in the pelvic cavity of a 52-year-old male patient

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