Squamous Cell Carcinoma Of Colon Research Articles

Squamous Cell Carcinoma of Colon: A Case Series of a Rare Histology

Squamous Cell Carcinoma of Colon: A Case Series of a Rare Histology

Sigmoid Squamous Cell Carcinoma Presenting as a Bladder Mass: A Case Report

Primary squamous cell carcinoma (SCC) of the colon and rectum is a rare malignancy, with an incidence of less than 1 in 1,000 diagnosed colorectal cancers. This is a case of a 59-year-old male who presented with a three-month history of urinary symptoms. Work-up, however, revealed a locally-advanced, partially-obstructing primary sigmoid squamous cell carcinoma with extension to the urinary bladder. He subsequently underwent a proximal bowel diversion after extensive carcinomatosis was discovered on diagnostic laparoscopy. Colon SCC represents less than 0.5% of all colorectal tumors, and its incidence is estimated to be 0.1%. Clinically, it presents with similar signs and symptoms as colorectal adenocarcinoma. No standardized management approach has been established yet. A multidisciplinary team approach is essential in dealing with such cases. Keen attention and further investigation are warranted to clearly define the management approach to achieve better outcomes. Key words: colorectal cancer, squamous cell cancer, urinary bladder, rectum

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

Introduction and importanceSquamous 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 presentationA 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 discussionPrimary 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.ConclusionSurgery 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.

S1987 Go With Your Gut Feeling: A Case of Invasive Colonic Squamous Cell Carcinoma Not Detected by DNA-Based Stool Testing

Introduction: Though less common, colonic squamous cell carcinoma is a type of colorectal cancer. Current colorectal cancer screening recommendations for average-risk patients include the use of stool DNA-based testing as an alternative to screening colonoscopy. This clinical vignette is an example of colonic squamous cell carcinoma that went undetected by a stool DNA-based colorectal cancer screening test. Case Description/Methods: 57 year-old female with no prior medical history presented to outpatient gastroenterology office for evaluation of tenesmus, mucus in stool with associated diarrhea and LLQ pain of 3 months duration. Physical exam was unremarkable. Recent CBC, BMP, and albumin were within normal limits. Patient had undergone average-risk colorectal cancer screening with a stool DNA-based test 11 months prior to presentation (8 months prior to symptom onset) with a negative result. Patient was asymptomatic at the time of the screening test. Due to her new symptoms, it was recommended she undergo infectious stool studies and colonoscopy. C difficile screen, bacterial stool culture and parasitology exam were negative. Colonoscopy revealed a 6-cm partially circumferential frond-like/villous, infiltrative and ulcerated partially obstructing large mass 4-11cm from the anal verge (Figure 1A, B). Biopsy was positive for invasive squamous cell carcinoma. The patient was referred to oncology and completed definitive chemo-radiation therapy with no evidence on residual disease on most recent imaging. Discussion: This case demonstrates an average-risk patient who underwent stool DNA-based testing for colorectal cancer screening that was negative with subsequent presentation and diagnosis of invasive squamous cell carcinoma of the colon in less than one year’s time. It highlights the importance of colorectal cancer screening and the ability of colonoscopy to detect and diagnosis colorectal cancer. DNA-based stool testing is an alternative non-invasive screening test to colonoscopy in average-risk patients. The current data supports a false negative rate of DNA-based stool testing to be less than 1 in 1500. However, the presence of a false negative test provides patients with a false sense of confidence and reassurance that they do not have cancer. It is imperative that for any new lower GI symptoms or other clinical suspicion for colorectal malignancy, the patient should still undergo evaluation with colonoscopy – endoscopic evaluation should not be deferred because of a recent negative DNA-based stool test.Figure 1.: A. Colon with mass, B. Detailed view of ulcerated mas.

S1734 A Rare Case of Non-Small Cell Lung Carcinoma With Metastasis to the Colon: A Case Report

Introduction: Squamous Cell Carcinoma (SCC) when found in the Lung is classified as Non-Small Cell Lung Carcinoma (NSCLC). It has a high potential to metastasize most commonly to the brain, liver, or bone. We present a rare case of metastasis of NSCLC to the colon leading to constipation. Case Description/Methods: This is a case of a 58-year-old male with a history of NSCLC with known metastasis to the subcutaneous abdomen, liver and spleen. The patient was on maintenance therapy with nab-paclitaxel and underwent a Computer Topography (CT) Chest and Abdomen to evaluate for disease progression. The CT revealed a circumferential mass at the hepatic flexure (Figure 1a & 1b) suspicious for a colonic neoplasm. In the Gastroenterology clinic he endorsed right upper quadrant abdominal pain and worsening constipation but denied weight loss, overt bleeding or change in stool caliber. He underwent a colonoscopy which revealed an ulcerated, partially-obstructing circumferential mass at the hepatic flexure (Figure 2a). The mass was biopsied and tattooed for localization (Figure 2b). The pathology revealed metastatic NSCLC. Surgery was consulted and the patient was scheduled for a right hemicolectomy with end ileostomy and mucus fistula. Discussion: Primary colonic SCC is a rare entity making up less than 1% of colon carcinomas, while 95% are adenocarcinomas. NSCLC with metastasis to the colon is also considered rare with few cases reported in the literature and accounts for 0.5% of lung cancer cases. NSCLC most commonly metastasizes to the brain, liver or bone. This happens when NSCLC invades local lymph nodes and can then enter the lymphatic system eventually spreading hematologically. SCC usually arises from a mutation of the p53 gene, by inhibiting apoptosis of abnormal cells. This then progresses into a lesion and can eventually spread to metastatic disease by seeding to other parts of the body. When it happens in the colon, the presentation is similar to all colorectal cancers; rectal bleeding, abdominal pain, change in bowel habits, change in stool caliber, and weight loss. In our patient a CT scan to monitor for progression discovered a lesion in the colon. Colonoscopy was performed to differentiate between primary and metastatic disease. To date no guidelines on the management of cases like this exist, however surgical resection with chemotherapy is considered the best management. This case illustrates that while rare a metastatic SCC should be in the differential when evaluating patients with colonic lesions.Figure 1.: Figure 1a & b: CT abdomen revealed a circumferential mass at the hepatic flexure of the colon.Figure 2.: a & b: Colonoscopy showed a mass that was biopsied and tattooed for localization.

Primary squamous cell carcinoma of the sigmoid colon: a case report and literature review

Primary squamous cell carcinoma of the colon is extremely rare. The etiology is poorly understood, and currently, there are different hypotheses about the origin of this malignant neoplasm. Here, we r 87-year-old male with a moderately-differentiated nonkeratinizing squamous cell carcinoma of the colon.

A Large Invasive Primary Squamous Cell Carcinoma of Colon: A Case Report and Literature Review

Primary squamous cell carcinoma (SCC) of colon is a rare histopathologic type of colon cancers. In this article we report a case of a large invasive primary colon SCC mass proven by pathologic examinations at rectosigmoid level with extensive adhesions to vasculature and hydronephrosis due to pressure effectson ureter. We excised the whole mass and dissected all para-aortic and pelvic lymph nodes. Patient was referred to oncology ward for further treatments.

Basic characteristics and therapy regimens for colorectal squamous cell carcinoma

Background: Colorectal cancer (CRC) is one of the leading causes of cancer-related deaths, and squamous cell carcinoma (SCC) is a rare histological type. Due to the lack of cases, there is no standard treatment for colorectal SCC. Methods: In our study, we compiled data from the Surveillance, Epidemiology, and End Results Program (SEER) database between 1988 and 2014 and analyzed overall survival (OS) between groups stratified by histological type, primary tumor site or treatment regimens. The SEER-Medicare database was also used to analyze the treatment regimens in the groups stratified by tumor-node-metastasis (TNM) stage. Results: Our results show that the colorectal SCC was commonly seen in females, and tends to have higher pT category and TNM stage. The 5-year survival rate for colorectal SCC was much lower than adenocarcinoma or mucinous adenocarcinoma and higher than signet ring cell carcinoma. Patients with rectal SCC also showed better prognosis compared with colon SCC. The colorectal patients received surgery with chemoradiotherapy or chemoradiotherapy alone have a significantly better prognosis than receiving surgery alone in SEER database. For stage I–III colorectal SCC patients who underwent an operation, chemotherapy and radiotherapy could improve the prognosis but failed to reach statistical significance, and chemotherapy is also an independent prognosis factor which could significantly improve the prognosis of stage IV colorectal SCC in SEER-Medicare database. Conclusions: The OS rate for colorectal SCC is much lower than for adenocarcinoma and mucinous adenocarcinoma. Rectal SCC patients had better prognosis than colonic SCC.

Metastatic squamous cell carcinoma of colon from esophageal cancer

BackgroundEsophageal cancer including squamous cell carcinoma (SCC) and adenocarcinoma represents 4% of all cancers in the United States. Patients with esophageal cancer frequently present with locally advanced disease, and about 40% of patients have evidence of metastatic disease on presentation. Common sites of metastasis include liver, lung and bone. Here, we present a rare case of colonic metastasis from primary esophageal SCC.Case presentationA 60-year-old Caucasian male with a history of 20-pack-year cigarette smoking received surgery and adjuvant chemoradiotherapy for locally advanced SCC of larynx. Approximately 9 months later, he developed dysphagia, and found to have a esophageal SCC in the mid-esophagus with regional lymph node involvement. He underwent chemoradiation treatment with good response and improved symptoms but declined subsequent surgical resection for esophageal cancer. About 1 year after the diagnosis of esophageal cancer, he developed blood streaked bowel movement and severe anemia. Colonoscopy showed a 3-cm mass in the proximal ascending colon; biopsy showed metastatic SCC, consistent with metastasis from esophageal primary. He subsequently received palliative radiation to the ascending colon metastatic tumor with improvement of anemia, and remained transfusion independent for more than 3 months.ConclusionsColonic metastasis from esophageal SCC is rare, and associated with poor prognosis. There are no definite features in terms of location, histological differentiation etc. that contribute to colonic metastasis from primary esophageal SCC. The goal of treatment is palliative and data from our and other case reports support the use of chemotherapy and radiation for symptom improvement and disease control.

Gemcitabine-based chemotherapy in colon squamous cell carcinoma: A case report and literature review.

Squamous cell carcinoma (SCC) originating from the colon is rare. In terms of its clinicopathological characteristics, this type of cancer has been reported to be more aggressive and have a worse prognosis compared with adenocarcinoma. We herein present a successful therapeutic approach applying neoadjuvant and adjuvant gemcitabine-based chemotherapy in a patient with colon SCC. A 58-year-old male patient received two cycles of neoadjuvant chemotherapy with a regimen including gemcitabine, oxaliplatin and capecitabine, followed by radical excision and six cycles of adjuvant chemotherapy. Contrast-enhanced computed tomography and serum tumor markers were used for reassessment and evaluation was based on the World Health Organization criteria. Following neoadjuvant chemotherapy, the mass had shrunk and the patient was classed as having stable disease. Surgery and adjuvant chemotherapy were then performed and the patient had achieved a progression-free survival of 10 months when this report was submitted. Therefore, gemcitabine may be a treatment option for colon SCC in the neoadjuvant and/or adjuvant chemotherapy setting.

Opportunistic Intestinal Infections and Risk of Colorectal Cancer Among People with AIDS

Because mucosal inflammation contributes to colorectal carcinogenesis, we studied the impact of intestinal infections on risk of this malignancy among people with AIDS (PWA). Using the population-based HIV/AIDS Cancer Match, which includes approximately half of all PWA in the United States, the cancer registries ascertained colorectal cancers (ICD-O3 codes C180-C189, C199, C209, and C260). During 4-120 months after AIDS onset, risk of cancer occurring after AIDS-defining intestinal infections (considered as time-dependent exposures) was estimated with hazard ratios (HR) and 95% confidence intervals (CI) calculated by Cox regression. Analyses included cancers overall and by histology and anatomic site. After excluding 118 squamous cell rectal cancers (possible anal cancers), we analyzed 320 incident colorectal cancer cases that occurred among 471,909 PWA. Colorectal cancer risk was marginally elevated following cryptosporidiosis (HR=2.08, 95% CI=0.93-4.70, p=0.08) and mucocutaneous herpes (HR=1.69, 95% CI=0.97-2.95, p=0.07) but not with Pneumocystis pneumonia (HR=0.79, 95% CI=0.57-1.10). Cryptosporidiosis was associated with rare colon squamous cell carcinoma [N=8, HR=13, 95% CI=1.5-110] and uncommon histologies [HR=4.4, 95% CI=1.1-18, p=0.04], but it was not associated with colorectal adenocarcinoma (N=269, HR=1.3, 95% CI=0.4-3.9, p=0.70). Mucocutaneous herpes was associated with colon squamous cell carcinoma (HR=13, 95% CI=2.4-67, p=0.003) but not with colorectal adenocarcinoma (HR=1.3, 95% CI=0.6-2.6, p=0.52) or uncommon histologies (HR=2.5, 95% CI=0.8-8.2, p=0.13). Colon squamous cell carcinoma risk was significantly elevated among PWA who had cryptosporidiosis or mucocutaneous herpes. These findings might suggest that HPV or inflammation from other infection may contribute to carcinogenesis.

Adenosquamous Cell Carcinoma of the Colon

Purpose: A 36-year-old woman with ulcerative colitis (UC) had a total proctocolectomy for differentiated adenocarcinoma (T1N0M0) three years prior to the current presentation of three months of epigastric pain with radiation to her back. Examination revealed epigastric fullness without a palpable mass. CEA was 7 ng/mL (nl:0-3ng/mL) and CA19-9 was 1022 units/mL (nl:<37units/mL). Two solid pancreatic masses were identified on CT. EUS-FNA samples of the body and the neck of the pancreas were positive for squamous cell carcinoma (SCC). Immunohistochemical staining revealed that the tumor was strongly positive for p16. In situ hybridization for HPV was negative. Given the rarity of primary pancreatic SCC slides from the patient's previous proctocolectomy were reviewed. Similar to the pancreatic tumor, the colonic tumor was p16 positive, HR-HPV negative and had foci suggestive of squamous differentiation. The pathology was felt to be most consistent with pancreatic metastasis from a colon primary, rather than a de novo lesion. Conclusion: Pure SCC in the pancreas is a metastatic lesion until proven otherwise. One of the most common sites of primary tumors metastatic to the pancreas is the colon. Despite the prevalence of adenocarcinoma of the colon; combined, pure SCC and mixed adenosquamous (Ad-SCC) account for 0.1% of colon cancers. However, in patients with UC the relative incidence is reported to be 1.7%. The squamous component of Ad-SCC metastasizes more frequently and is more aggressive than the glandular counterpart. While the mechanism that gives rise to Ad-SCC of the colon is not well understood, basal cells proliferation as a response to mucosal injury, squamous metaplasia of glandular epithelium as a response to chronic inflammation and squamous differentiation of adenomas or adenocarcinomas, are possible explanations. The rarity of colorectal Ad-SCC and SCC complicates establishment of accurate prognosis and makes treatment selection difficult, Miyamoto, et al. believe that surgical resection is a better first line approach. Adjuvant treatment may be considered if the patient has a good performance status. Both Ad-SCC and SCC of the colon are rare tumors. Several published reports suggest an increased incidence in patients with UC. However, Cheng, et al. have questioned whether irritable bowel disease (IBD) is an etiological factor or if the increased numbers of SCC identified in patients with IBD is due to a selection bias; as these patients have surveillance colonoscopy more frequently than the average population. At present, any evidence based conclusions regarding etiology or treatment of pancreatic SCC, colonic SCC and Ad-SCC remain elusive.

Detection of Human Papillomavirus Type 16 in Squamous Cell Carcinoma of the Colon and Its Lymph Node Metastases with PCR and Southern Blot Hybridization

The etiological role of human papillomavirus (HPV) in a number of squamous malignant tumors is well known. Squamous cell carcinoma (SCC) of colon is a rare disease with uncertain etiology. Our objective was to detect possible HPV infection in a colon SCC patient. The 94-year-old female patient was operated due to colon tumor causing passage disturbances. Histology confirmed SCC. Tumor tissue and the removed lymph nodes were examined with polymerase chain reaction and Southern blot hybridization techniques. Of HPV types most often occurring in malignant tumors (16, 18) the presence of HPV type 16 could be confirmed in the primary tumor and in four out of the nine surrounding lymph nodes, of which two were metastatic. HPV-16 infection could be detected in an SCC patient in the primary tumor and in surrounding lymph nodes. According to our knowledge, no similar study has been published yet.

Asymptomatic colonic metastases from primary squamous cell carcinoma of the lung with a positive fecal occult blood test

We describe a 74-year-old man with a colonic metastatic squamous cell carcinoma (SCC) from the lung. His chest X-ray revealed an abnormal shadow in the right upper lobe. Computed tomography (CT) of the chest demonstrated a large lung tumor in the right upper lobe obstructing the right upper bronchus. Bronchoscopy revealed an easy-bleeding tumor in the right upper bronchus that was diagnosed as poorly differentiated squamous cell lung carcinoma. He underwent colonoscopy because he had a positive fecal occult blood test. Colonoscopy revealed a large protruding lesion with central ulceration in the descending colon. Histological examination of the biopsy specimen obtained from the colonic lesion revealed SCC. The lesion was diagnosed as metastatic colonic SCC. He had no abdominal symptoms. He underwent chemotherapy with an infusion of cisplatin 130 mg i.v. day 1, and docetaxel hydrate 100 mg i.v. day 1, repeated every 4 wk, followed by 4 courses of chemotherapy. The primary lesion shrank by less than 10% and was judged to be "Partial Response" (PR) after 3 courses of treatment. The patient still lived 23 wk after the diagnosis of metastatic colonic SCC. Colonic metastasis of primary SCC of the lung is rare.

Colonic Squamous Cell Carcinoma in Ulcerative Colitis: Report of a Case and Review of the Literature

Squamous cell carcinoma (SCC) is a rare neoplasm in the colorectum. A case of SCC rising from an area of squamous metaplasia in the rectum is presented in a patient with long-standing ulcerative colitis and perianal warts. This is the first report in the literature describing the evolution of squamous metaplasia in the colonic mucosa into invasive carcinoma over time. Related literature on colorectal SCC and squamous metaplasia, and their relationships with inflammatory bowel disease and human papilloma virus, is reviewed.

Squamous Cell Carcinoma of the Colon with an Elevated Serum Squamous Cell Carcinoma Antigen Responding to Combination Chemotherapy

Primary squamous cell colorectal carcinomas are uncommon, and their characteristics are not well known. They seem to occur most commonly in the fifth decade of life with a slight predominance for men. The most commonly reported anatomic locations are the rectum and the proximal colon. Clinical features and common diagnostic methods do not easily differentiate squamous cell colorectal carcinomas from adenocarcinomas. Because of their extremely rare occurrence, it is difficult to study their natural course, clinical behavior, and response to therapy. This report presents the case of a pure squamous cell colorectal cancer and provides a brief review of the literature, which includes 60 previously published cases. The case of a patient with T3N2M0 primary squamous cell carcinoma of the rectosigmoid colon, which was initially treated with abdominoperineal resection followed by adjuvant chemotherapy and radiation, is presented. During the follow-up, an elevated squamous cell carcinoma antigen (SCC Ag) level led to restaging computed tomography scans, which confirmed recurrent metastatic disease in the liver. Response to chemotherapy with a decrease in tumor size correlated with a decrease in the serum SCC Ag level. Although SCC Ag has been used as a tumor marker for squamous cell cancers of the lung, head and neck, uterine cervix, and esophagus, this is the first reported case of a squamous cell colon carcinoma presenting with an elevated SCC Ag at the time of recurrence. In addition, this patient showed an objective partial response to combination chemotherapy, with a decrease in the serum level of this tumor marker.

Primary squamous cell carcinoma of the colon arising in a villous adenoma

The first case of pure squamous cell carcinoma arising in a villous adenoma of the cecum is reported, and the literature of squamous cell carcinoma of the colon is reviewed. The possible origin of this neoplasm in adenomas of the colon, similar to that of adenocarcinoma, is discussed, and the site distributions of adenocarcinoma and squamous cell carcinoma are compared. The distribution of primary colonic squamous cell carcinoma is found to be predominantly right-sided in comparison to adenocarcinoma (p less than 0.05). Although this result does not preclude adenomas as the origin of most squamous cell carcinomas, it suggests the influence of as yet unknown site-asymmetric factors that are different from those for adenocarcinoma.