Open Access
Open Peer Review

This article has Open Peer Review reports available.

How does Open Peer Review work?

Squamous cell carcinoma of rectum presenting in a man: a case report

  • A Syed Sameer1, 2, 3,
  • Nidda Syeed1,
  • Nissar A Chowdri3,
  • Fazl Q Parray3 and
  • Mushtaq A Siddiqi1Email author
Journal of Medical Case Reports20104:392

https://doi.org/10.1186/1752-1947-4-392

Received: 8 December 2009

Accepted: 30 November 2010

Published: 30 November 2010

Abstract

Background

Primary squamous cell carcinomas of the colorectum are very uncommon. Until now, to the best of our knowledge, only 114 cases of squamous cell carcinoma in the colorectum exist in the reported literature. Here we report a case of squamous cell carcinoma of the rectum in the ethnic Kashmiri population in northern India.

Case Presentation

The case of a 60-year-old male patient (Asian) with a pure squamous cell carcinoma of the rectum is presented here. The patient underwent a curative surgery with concomitant chemotherapy. Two years after the initial curative resection of the tumor he is still alive.

Conclusion

The prognosis for squamous cell carcinoma of the colorectum is worse than for that of adenocarcinoma, because of the delayed diagnosis. The etiopathogenicity of squamous cell carcinoma of the colorectum is discussed. Surgical resection of the lesion seems to be the treatment of choice. Chemotherapy also helps in improvement of the prognosis.

Introduction

The occurrence of squamous cell carcinomas (SCC) in the colorectum is a rare entity representing a small fraction of colorectal malignancies, since more than 90% of colorectal diseases are adenocarcinoid tumors [1]. Very little information is available in the literature about the etiology, prognosis and optimal treatment of this malignancy [2]. Here in this study, we describe a patient with SCC of the rectum who underwent a lower anterior resection (LAR) for the possible treatment of the malignancy.

Case presentation

A 60-year-old male patient from an urban area of Kashmir (Asian) visited the Department of General Medicine of our institute with the chief complaints of severe lower-abdominal pain for the past eight months. The patient also complained of severe constipation, nausea, vomiting, anorexia, loss of appetite, abdominal cramps, incontinence of faeces and weight loss during the past four months. He experienced profuse bleeding from the rectum for the last month. Initial interviews with the patient revealed that the he was a heavy smoker and frequent user of noon-chai (Salt tea), meat and pickles. On examination the patient was found to be anemic. Digital rectal examination revealed an ulcero-infiltrative lesion with restricted mobility about 4 cm from the anal verge on the left lateral wall. A colonoscopy confirmed the rectal examination and biopsies taken at the time of the colonoscopy revealed squamous cell carcinoma (SCC) of basal cell type in the first histopathological examination. The report was re-confirmed by a second independent pathologist. A Contrast-Enhanced Computed Tomography (CECT) of the chest, abdomen and pelvis was also done but no lesions were found in any other site than the rectum. The lesion was without any fat stranding or lymphadenopathy. Furthermore, following the provisional diagnosis, the patient was referred to the Department of General Surgery for radical treatment, where he underwent LAR of the rectum using the standard technique of mesorectal excision (Figure 1). The continuity of the gut was restored by a circular stapler for low colorectal anastomosis with formation of a colonic pouch. The colonic pouch takes over the function of rectal reservoir which is lost after excision of the middle and lower rectum. Microscopic examination of the resected lesion demonstrated a 2.5 cm × 3 cm SCC tumor of the rectum infiltrating the serosa. The margins of the excised tissue were found to be free of the tumor. However, four regional lymph nodes were also infiltrated by the metastatic SCC cells. The liver and the rest of the organs were free of any metastasis. The slides were reviewed by a third histopathologist who reported the lesion as poorly differentiated squamous cell carcinoma. The stage of the tumor was found to be T3N2Mo. The post-operative period was uneventful. Post-operatively the patient received four cycles of chemotherapy with cisplastin and 5-fluorouracil for five days. The patient is on two years of follow-up and has not shown any evidence of recurrenceas of the present time.
Figure 1

Image showing the inner lining of the colon with a rosette-shaped malignant tumor at the lateral wall of the rectum.

Discussion

Colorectal cancer (CRC) is the third most common cause of cancer-related death in the world [3]. Almost 90% of CRC are adenocarcinomas, while the remaining 10% are made up of carcinomas, sarcomas and lymphoid tumors [1]. The occurrence of SCC in the gastrointestinal tract (GIT) is a rare phenomenon, and its occurrence in the colorectum is extremely unusual [4]. The incidence of SCC of the colorectum has been reported to be almost 0.1 to 0.25 per 1000 CRC [4, 5]. A look into the research work and the reported cases of SCC dates back to 1907, when Herxheimer reported adenosquamous carcinoma of the cecum but it was in 1919 when the first case of pure SCC of the colon was reported by Schmidtmann [6] in a 65-year-old man [7]. It was not until 1933 that the first case involving the rectum was subsequently described by Raiford [8]. In India, Bhat et al. [9] reported the first case of pure SCC of the colon in 1993 in a 55-year-old female from the southern part of the country. Until now almost 120 cases of SCC have been reported from all over the world (See Table 1). Surprisingly, a study from Russia reported 107 cases of SCC from a single center alone [10] but there has been no such reports of high incidence of SCC in the colorectum from any other part of the world.
Table 1

Reported cases of squamous cell carcinoma of the colorectum (Data available from 1933 to 2009)

Study number

Study

Age

Sex

Surgery

Outcome

01.

Schmidtmann (1919) [6]

65

M

NA

Died after 1 m

02.

Raiford (1933) [8]

43

F

NA

Died after 7 m

03.

Catell et al. (1943) [22]

63

M

LAR

Alive at 3.5 y

04.

Wiener et al. (1962) [23]

52

F

APR

Died at 1 y

05.

Larizaden and Powell (1965) [24]

44

F

APR

Died at 1 y

06.

Cabrera et al. (1967) [25]

62

F

APR

NR

  

50

F

 

NR

07.

Minkowitz et al. (1967) [26]

49

F

Proctocolectomy

Died after 5 m

08.

Gaston et al. (1967) [27]

65

M

Hemicolectomy

Alive at 2 y

09.

Pemberton and Lendrum (1968) [28]

48

F

Hemicolectomy

Alive at 2 y

10.

Birnbaum et al. (1970) [29]

82

M

Hemicolectomy

NR

11.

Corner et al. (1971) [14]

34

F

APR

Alive at 13 y

12.

Lewis et al. (1971) [30]

61

M

Hemicolectomy

Died after 10 d

13.

Balfour (1972) [31]

63

M

NA

Died after 18 m

14.

Horne and McCulloch (1978) [32]

53

M

Hemicolectomy

Died after 11 m

15.

Crissmann (1978) [33]

72

M

Colectomy

Died after 3 d

16.

Burgess et al. (1979) [34]

43

M

Hemicolectomy

Died after 11 m

17.

Williams et al. (1979) [11]

45

M

APR

Died after 9 m

18.

Lasser et al. (1980) [35]

65

F

N/A

Alive at 3 y

  

48

F

N/A

Alive 8 m

  

54

M

N/A

Alive 17 m

19.

Hickey and Corson (1981) [36]

48

F

Hemicolectomy

Alive at 21 m

20.

Petrelli et al. (1981) [37]

73

M

Colectomy

Died after 9 d

21.

Pitella and Torres (1982) [38]

33

M

Ileocolic bypass

Died after 10 d

22.

Hey and Brandt (1982) [39]

NA

NA

NA

NA

  

NA

NA

NA

NA

23.

Lyttle et al. (1983) [40]

65

F

Hemicolectomy

Alive at 2 m

24.

Vezeridis et al. (1983) [41]

56

M

APR

Died after 10 m

  

44

M

APR

Died after 9 d

  

61

F

 

Died after 4 m

  

66

F

 

Died after 15 m

  

62

F

APR

Died after 13 m

25.

Gould et al. (1983) [42]

61

M

Ileocolic bypass

Died after 3 m

26.

Francioni et al. (1983) [43]

NA

NA

NA

NA

27.

Forouhar et al. (1984) [44]

NA

NA

NA

NA

28.

Lafreniere et al. (1985) [13]

60

M

TAE

Alive at 2 y

29.

Balsano et al. (1985) [45]

65

M

Hemicolectomy

NA

  

58

M

Hemicolectomy

NA

30.

Chulia et al. (1986) [46]

NA

NA

NA

NA

31.

Weidner and Zekan, (1986) [47]

73

M

NA

Died after 4 y

32.

Piggott and Williams (1987) [48]

60

F

APR

Alive at 13 m

33.

Woods et al. (1987) [49]

57

F

APR

Died after 3 m

34.

Shao et al. (1987) [50]

NA

NA

NA

NA

35.

Prener et al. (1988) [51]

43

F

APR

Died after 1 y

  

77

F

Polypectomy

Died after 3 y

  

55

F

APR

Alive at 3 y

  

55

M

APR

Died after 3 m

  

53

M

APR

Died after 1 y

36.

Lundquest et al. (1988) [52]

NA

NA

NA

NA

37.

Wyatt (1991) [53]

71

M

NA

Alive at 1 y

38.

Schneider et al. (1992) [54]

44

M

 

NA

  

69

F

TAE

Alive at 3 y

39.

Betancourt et al. (1992) [55]

NA

NA

NA

NA

40.

Vignale et al. (1993) [56]

69

M

NA

NA

41.

Yoshida et al. (1994) [57]

51

M

Hemicolectomy

Died after 39 d

42.

Vraux et al. (1994) [58]

NA

NA

Chemotherapy

Died after 5 y

43.

Alekseev et al. (1994) [59]

NA

NA

NA

NA

44.

Petrelli et al. (1996) [60]

62

M

APR

NA

  

41

F

Colectomy

NA

45.

Martinez-Gonzalez et al. (1996) [61]

40

M

LAR

Alive at 18 m

46.

Juturi et al. (1998) [62]

61

F

Hemicolectomy

Alive at 18 y

  

61

M

Hemicolectomy

Died after 15 m

47.

Kim et al. (2001) [63]

41

F

LAR

Died after 4 m

48.

Copur et al. (2001) [64]

54

M

APR+CT

NA

49.

Sotlar et al. (2001) [65]

87

M

LAR

Died after 20 m

50.

Frizelle et al. (2001) [66]

9 cases

   

51.

Gelas et al. (2002) [2]

47

F

APR+CT

Alive at 16 y

  

63

M

APR+CT

Died after 14 m

  

70

F

APR

Died after 18 m

  

93

M

 

Died after 4 m

  

45

F

LAR

Alive at 6 m

  

43

F

LAR

Alive at 2 y

52.

Bhat et al. (2003) [9]

55

F

Hemicolectomy

NA

53

Kim, 2005 [67]

71

M

 

NA

54.

Anagnostopoulos et al. (2005) [7]

75

M

APR

Alive at 14 m

55.

Lam et al. (2006) [68]

44

F

LAR

NA

56.

Theodosopoulos et al. (2006) [21]

39

F

APR

Alive at 18 m

57.

Ambrosini-Spaltro et al. (2006) [69]

81

M

Hemicolectomy

Alive at 2 y

58.

Pikarsky et al. (2006) [70]

57

F

 

Alive at 7 yr

59.

Nahas et al. (2007) [5]

58

F10/M2

 

Alive at 2.6 yr

60.

Miyamoto (2007) [1]

89

M

Colectomy

Died after 3 m

61.

Cheng et al. (2007) [71]

51

F

Proctocolectomy

NA

62.

Kong et al. (2007) [72]

48

F

TAE

Alive at 3 y

  

53

F

NA

 

63.

Clark et al. (2008) [73]

75

M

 

Alive at 20 m

  

71

F

 

Alive at 31 m

  

42

F

 

Alive at 13 m

  

70

M

 

Alive at 14 m

  

55

F

LAR

Alive at 19 m

  

45

F

 

Alive at 23 m

  

71

F

 

Alive at 5 m

64.

Rasheed et al. (2009) [74]

55

F

 

Alive at 11 y

  

50

M

 

Alive at 7 y

  

69

F

 

Alive at 4 y

  

61

M

APR

Alive at 4 y

  

58

M

APR

Alive at 2 y

  

41

F

 

Alive at 2 y

65.

Our Case

60

M

LAR

Alive at 15 m

NA: not available; F: female; M: male; LAR: low anterior resection; APR: abdominoperineal resection; TAE:transanal excision; y: years; m: months and d: days

Before the diagnosis of primary SCC of colorectum is made, certain criteria must be fulfilled as given by Williams et al. in 1979 [11]. This criteria includes: (A) absence of evidence of squamous cell carcinoma of any other part of the body, ruling out any chance of possible metastasis from any organ to the colorectal site; (B) exclusion of any proximal extension of anal squamous cell carcinoma; (C) absence of fistulous tract lined by squamous cells; and (D) confirmation of SCC by histological analysis [1, 4, 12]. All of these criteria were fulfilled by our case.

A look at the available literature reveals that squamous cell carcinoma of the colorectum affects individuals with a mean age of 55 to 60 years Women are more frequently predisposed to SCC than men, around 66% of cases occurred in women and 34% in men. Furthermore, SCC occurs in concomitance with an advanced tumor stage (Duke's C) [4, 13]. Since SCC of the rectum is a rare tumor, epidemiological data constituting patient demographics, risk factors and natural history are lacking in the literature. The clinical characteristics of the patients with SCC of the colorectum are similar to those with adenocarcinoma: rectal bleeding, abdominal pain, change in bowel habits and weight loss [4]. Because of the rare nature of this malignancy the prognosis for patients is difficult to establish, Comer et al. suggested a poorer prognosis for patients with colorectal SCC than adenocarcinoma [1, 4, 14].

Almost four different pathophysiological theories regarding the origin of squamous cell carcinoma of the colorectum have been proposed in the literature so far. These can be summarized as: (A) Proliferation of uncommitted basal cells into squamous cells which undergo malignant transformation following mucosal injury [15]; (B) Ability of pluripotent stem cells to undergo spontaneous squamous differentiation [16]; (C) Squamous metaplasia of glandular epithelium resulting from chronic inflammation or irritation, secondary to inflammatory bowel disease [17], infection [18] or radiation [19]; (D) Origin from embryonal nests of ectodermal cells; and (E) Arousal of carcinomas from preexisting adenomas or adenocarcinomas [7, 20].

Conclusion

In conclusion, advanced colorectal SCC has a poor prognosis. Since colorectal SCC is a very rare disease, treatment selection is difficult. However, surgical resection and adjuvant chemotherapy [21] is a better approach to the treatment of colorectal SCC.

Consent

Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available with the corresponding author of this manuscript and is accessible for review by the Editor-in-Chief of this journal

Declarations

Acknowledgements

The authors gratefully acknowledge the Sher-I-Kashmir Institute of Medical Sciences, Kashmir for providing funds for this research work. The authors also gratefully acknowledge the technical staff, especially Miss Roohi and Mr. Reyaz of the Department of General Surgery for helping in the procurement of tumor tissue samples from the Operation Theater. We also thank the anonymous pathologists of the Department of Pathology for the histopathological assessment of the tumor tissues.

Authors’ Affiliations

(1)
Department of Immunology and Molecular Medicine, Sher-I-Kashmir Institute of Medical Sciences, Soura
(2)
Department of Clinical Biochemistry, Sher-I-Kashmir Institute of Medical Sciences, Soura
(3)
Department of General Surgery, Sher-I-Kashmir Institute of Medical Sciences, Soura

References

  1. Miyamotoa H, Nishiokaa M, Kuritaa N, Hondaa J, Yoshikawaa K, Higashijimaa J, Miyatania T, Bandoub Y, Shimadaa M: Squamous cell carcinoma of the descending colon: report of a case and literature review. Case Rep Gastroenterol. 2007, 1: 77-83. 10.1159/000107470.View ArticleGoogle Scholar
  2. Gelas T, Peyrat P, Francois Y, Gerard JP, Baulieux J, Gilly FN, Vignal J, Glehen O: Primary squamous-cell carcinoma of the rectum: report of six cases and review of the literature. Dis Colon Rectum. 2002, 45: 1535-1540. 10.1007/s10350-004-6462-z.View ArticlePubMedGoogle Scholar
  3. Sameer AS, Rehman S, Pandith AA, Syeed N, Shah ZA, Chowdhri NA, Wani KA, Siddiqi MA: Molecular gate keepers succumb to gene aberrations in colorectal cancer in Kashmiri population, revealing a high incidence area. Saudi J Gastroenterol. 2009, 15: 244-252. 10.4103/1319-3767.56102.View ArticlePubMedPubMed CentralGoogle Scholar
  4. Dyson T, Draganov PV: Squamous cell cancer of the rectum. World J Gastroenterol. 2009, 15: 4380-4386. 10.3748/wjg.15.4380.View ArticlePubMedPubMed CentralGoogle Scholar
  5. Nahas CS, Shia J, Joseph R, Schrag D, Minsky BD, Weiser MR, Guillem JG, Paty PB, Klimstra DS, Tang LH, Wong WD, Temple LK: Squamous-cell carcinoma of the rectum: a rare but curable tumor. Dis Colon Rectum. 2007, 50: 1393-1400. 10.1007/s10350-007-0256-z.View ArticlePubMedGoogle Scholar
  6. Schmidtmann M: Zur Kenntnis seltener Krebsformen. Virchow Arch (A). 1919, 226: 100-118. 10.1007/BF02039541.View ArticleGoogle Scholar
  7. Anagnostopoulos G, Sakorafas GH, Kostopoulos P, Grigoriadis K, Pavlakis G, Margantinis G, Vugiouklakis D, Arvanitidis D: Squamous cell carcinoma of the rectum: a case report and review of the literature. Eur J Cancer Care Engl. 2005, 14: 70-74. 10.1111/j.1365-2354.2005.00523.x.View ArticlePubMedGoogle Scholar
  8. Raiford TS: Epitheliomata of the lower rectum and anus. Surg Gynecol Obstet. 1933, 57: 21-35.Google Scholar
  9. Bhat S, Pai M, Premnath RP: Primary squamous cell carcinoma of caecum. Indian J Cancer. 2003, 40: 118-119.PubMedGoogle Scholar
  10. Mel'nikov RA, Goshchitskiĭ LG, Kovalev VK: Clinical manifestations of squamous cell carcinoma of the rectum. Vopr Onkol. 1984, 30: 76-83.PubMedGoogle Scholar
  11. Williams GT, Blackshaw AJ, Morson BC: Squamous carcinoma of the colorectum and its genesis. J Pathol. 1979, 129: 139-147. 10.1002/path.1711290306.View ArticlePubMedGoogle Scholar
  12. Carroll D, Rajesh PB: Colonic metastases from primary squamous cell carcinoma of the lung. Eur J Cardiothorac Surg. 2001, 19: 719-720. 10.1016/S1010-7940(01)00646-7.View ArticlePubMedGoogle Scholar
  13. Lafreniere R, Ketcham AS: Primary squamous carcinoma of the rectum. Report of a case and review of the literature. Dis Colon Rectum. 1985, 28: 967-972. 10.1007/BF02554319.View ArticlePubMedGoogle Scholar
  14. Comer TP, Beahrs OH, Dockerty MB: Primary squamous cell carcinoma and adenoacanthoma of the colon. Cancer. 1971, 58: 111-117.Google Scholar
  15. Michelassi F, Montag AG, Block GE: Adenosquamous-cell carcinoma in ulcerative colitis. Report of a case. Dis Colon Rectum. 1988, 31: 323-326.Google Scholar
  16. Ouban A, Nawab RA, Coppola D: Diagnostic and pathogenetic implications of colorectal carcinomas with multidirectional differentiation: a report of 4 cases. Clin Colorectal Cancer. 2002, 1: 243-248. 10.3816/CCC.2002.n.006.View ArticlePubMedGoogle Scholar
  17. Fu K, Tsujinaka Y, Hamahata Y, Matsuo K, Tsutsumi O: Squamous metaplasia of the rectum associated with ulcerative colitis diagnosed using narrow-band imaging. Endoscopy. 2008, 40: E45-E46. 10.1055/s-2007-966861.View ArticlePubMedGoogle Scholar
  18. Audeau A, Han HW, Johnston MJ, Whitehead MW, Frizelle FA: Does human papilloma virus have a role in squamous cell carcinoma of the colon and upper rectum?. Eur J Surg Oncol. 2002, 28: 657-660. 10.1053/ejso.2002.1304.View ArticlePubMedGoogle Scholar
  19. Yurdakul G, de Reijke TM, Blank LE, Rauws EA: Rectal squamous cell carcinoma 11 years after brachytherapy for carcinoma of the prostate. J Urol. 2003, 169: 280-10.1016/S0022-5347(05)64092-X.View ArticlePubMedGoogle Scholar
  20. Jaworski RC, Biankin SA, Baird PJ: Squamous cell carcinoma in situ arising in inflammatory cloacogenic polyps: report of two cases with PCR analysis for HPV DNA. Pathology. 2001, 33: 312-314. 10.1080/00313020120062901.View ArticlePubMedGoogle Scholar
  21. Theodosopoulos TK, Marinis AD, Dafnios NA, Vassiliou JG, Samanides LD, Carvounis EE, Smyrniotis VE: Aggressive treatment of metastatic squamous cell carcinoma of the rectum to the liver: a case report and a brief review of the literature. World Journal of Surgical Oncology. 2006, 4: 49-10.1186/1477-7819-4-49.View ArticlePubMedPubMed CentralGoogle Scholar
  22. Catell RB, Williams AG: Epidermoid carcinoma of the anus and rectum. Arch Surg. 1943, 46: 336-349.View ArticleGoogle Scholar
  23. Wiener MF, Polayes SH, Yidi R: Squamous carcinoma with schistosomiasis of the colon. Am J Gastroent. 1962, 37: 48-54.PubMedGoogle Scholar
  24. Larizaden R, Powell DE: Neoplastic change in a duplicated colon. Br J Surg. 1965, 52: 666-668. 10.1002/bjs.1800520907.View ArticleGoogle Scholar
  25. Cabrera A, Pickren JW: Squamous metaplasia and squamous-cell carcinoma of the rectosigmoid. Dis Colon Rectum. 1967, 10: 288-297. 10.1007/BF02617142.View ArticlePubMedGoogle Scholar
  26. Minkowitz S: Primary squamous cell carcinoma of the rectosigmoid portion of the colon. Arch Pathol. 1967, 84: 77-80.PubMedGoogle Scholar
  27. Gaston EA: Squamous-cell carcinoma of the colon and rectum: report of a case. Dis Colon Rectum. 1967, 10: 435-434. 10.1002/path.1711290306.View ArticlePubMedGoogle Scholar
  28. Pemberton M, Lendrum J: Squamous-cell carcinoma of the caecum following ovarian adenocarcinoma. Br J Surg. 1968, 55: 273-276. 10.1002/bjs.1800550409.View ArticlePubMedGoogle Scholar
  29. Birnbaum W: Squamous cell carcinoma and adenoacanthoma of the colon. JAMA. 1970, 212: 1511-1513. 10.1001/jama.212.9.1511.View ArticlePubMedGoogle Scholar
  30. Lewis PL, Harrer WV, Sencindiver PV: Primary squamous-cell carcinoma of the cecum: report of a case. Dis Colon Rectum. 1971, 14: 213-217. 10.1007/BF02553188.View ArticlePubMedGoogle Scholar
  31. Balfour TW: Does squamous carcinoma of the colon exist?. Br J Surg. 1972, 59: 410-412. 10.1002/bjs.1800590523.View ArticlePubMedGoogle Scholar
  32. Horne BD, McCulloch CF: Squamous cell carcinoma of the cecum: a case report. Cancer. 1978, 42: 1879-1882. 10.1002/1097-0142(197810)42:4<1879::AID-CNCR2820420427>3.0.CO;2-4.View ArticlePubMedGoogle Scholar
  33. Crissman JD: Adenosquamous and squamous cell carcinoma of the colon. Am J Surg Pathol. 1978, 2: 47-54. 10.1097/00000478-197803000-00006.View ArticlePubMedGoogle Scholar
  34. Burgess PA, Lupton EW, Talbot IC: Squamous-cell carcinoma of the proximal colon: report of a case and review of the literature. Dis Colon Rectum. 1979, 22: 241244-View ArticleGoogle Scholar
  35. Lasser P, Elias D, Eschwege F: A propos de 3 cas d'epitheliomas epidermoides du rectum. J Chir. 1980, 117: 377-380.Google Scholar
  36. Hickey WF, Corson JM: Squamous cell carcinoma arising in a duplication of the colon: case report and literature review of squamous cell carcinoma of the colon and of malignancy complicating colonic duplication. Cancer. 1981, 47: 602-609. 10.1002/1097-0142(19810201)47:3<602::AID-CNCR2820470330>3.0.CO;2-8.View ArticlePubMedGoogle Scholar
  37. Petrelli M, Tetangco E, Reid JD: Carcinoma of the colon with undifferentiated, carcinoid, and squamous cell features. Am J Clin Pathol. 1981, 75: 581-584.View ArticlePubMedGoogle Scholar
  38. Pittella JE, Torres AV: : Primary squamous-cell carcinoma of the cecum and ascending colon: report of a case and review of the literature. Dis Colon Rectum. 1982, 25: 483-487. 10.1007/BF02553663.View ArticlePubMedGoogle Scholar
  39. Hey A, Brandt G: [A pure squamous cell carcinoma of the large intestine. Report of 3 personal observations and a literature review]. Pathologe. 1982, 3: 359-364.PubMedGoogle Scholar
  40. Lyttle JA: Primary squamous carcinoma of the proximal large bowel. Report of a case and review of the literature. Dis Colon Rectum. 1983, 26: 279-282. 10.1007/BF02562498.View ArticlePubMedGoogle Scholar
  41. Vezeridis MP, Herrera LO, Lopez GE, Ledesma EJ, Mittleman A: Squamous-cell carcinoma of the colon and rectum. Dis Colon Rectum. 1983, 26: 188-191. 10.1007/BF02560169.View ArticlePubMedGoogle Scholar
  42. Gould L, Shah JM, Khedekar RR, Burns WA: Squamous cell carcinoma of the splenic flexure of the colon. Dig Dis Sci. 1983, 28: 918-922. 10.1007/BF01317044.View ArticlePubMedGoogle Scholar
  43. Francioni G, Canuti S, Cardelli A, Montesi M: [Epidermoid carcinoma of the colon. Clinical case of double recto-sigmoid basalioma]. Minerva Dietol Gastroenterol. 1983, 29: 33-38.PubMedGoogle Scholar
  44. Forouhar F: Neoplastic colonic polyp with extensive squamous metaplasia. Case report. Tumori. 1984, 70: 99-103.PubMedGoogle Scholar
  45. Balsano NA: Squamous cell carcinoma of the cecum. Arch Surg. 1985, 120: 1176-1177.View ArticlePubMedGoogle Scholar
  46. Chulia F, Camps C, Rodriguez A, Medina E, Tuset J: Epidermoid carcinoma of the colon. Description of a lesion located in the hepatic flexure. Dis Colon Rectum. 1986, 29: 665-667. 10.1007/BF02560334.View ArticlePubMedGoogle Scholar
  47. Weidner N, Zekan P: Carcinosarcoma of the colon - Report of a unique case with light and immuoistochemical studies. Cancer. 1986, 58: 1126-1130. 10.1002/1097-0142(19860901)58:5<1126::AID-CNCR2820580525>3.0.CO;2-Q.View ArticlePubMedGoogle Scholar
  48. Piggott JP, Williams GB: Primary squamous cell carcinoma of the colorectum: case report and literature review of a rare entity. J Surg Oncol. 1987, 35: 117-119. 10.1002/jso.2930350211.View ArticleGoogle Scholar
  49. Woods WG: Squamous cell carcinoma of the rectum arising in an area of squamous metaplasia. Eur J Surg Oncol. 1987, 13: 455-458.PubMedGoogle Scholar
  50. Shao YF, Pan GL, Zhou CN, Yu HT: : [Squamous cell carcinoma of the ascending colon--a case report and review of literature]. Zhonghua Zhong Liu Za Zhi. 1987, 9: 315-316.PubMedGoogle Scholar
  51. Prener A, Nielsen K: Primary squamous cell carcinoma of the rectum in Denmark. APMIS. 1988, 96: 839-844. 10.1111/j.1699-0463.1988.tb00951.x.View ArticlePubMedGoogle Scholar
  52. Lundquest DE, Marcus JN, Thorson AG, Massop D: : Primary squamous cell carcinoma of the colon arising in a villous adenoma. Hum Pathol. 1988, 19: 362-364. 10.1016/S0046-8177(88)80532-X.View ArticlePubMedGoogle Scholar
  53. Wyatt MG, Clarke TJ, Teasdale C: Primary squamous cell carcinoma of the caecum. Eur J Surg Oncol. 1991, 17: 392-394.PubMedGoogle Scholar
  54. Schneider TA, Birkett DH, Vernava AM: Primary adenosquamous and squamous cell carcinoma of the colon and rectum. Int J Colorectal Dis. 1992, 7: 144-147. 10.1007/BF00360355.View ArticlePubMedGoogle Scholar
  55. Betancourt C, Berríos G, Peña E: : [Squamous cell carcinoma of the colon. A case report]. G E N. 1992, 46: 331-335.PubMedGoogle Scholar
  56. Vignale R, Espasandin J, Deneo H, Gonzalez V: : Halo seborrheic keratosis associated with colon carcinoma. Int J Dermatol. 1993, 32: 846-10.1111/j.1365-4362.1993.tb02784.x.View ArticlePubMedGoogle Scholar
  57. Yoshida J, Tohma H, Nagata T, Okuzono Y, Takahashi M: Squamous cell carcinoma of the splenic flexure of the colon: report of a case. Surg Today. 1994, 24: 75-79. 10.1007/BF01676891.View ArticlePubMedGoogle Scholar
  58. Vraux H, Kartheuser A, Haot J, Humblet Y, Detry R, Dive C, Kestens PJ: Primary squamous-cell carcinoma of the colon: a case report. Acta Chir Belg. 1994, 94: 318-320.PubMedGoogle Scholar
  59. Alekseev VS, Boĭkov VP, Pavlov NV, Karyshev PB: [Squamous cell cancer of the colon with inflammation]. 1994, Khirurgiia Mosk, 12: 58-Google Scholar
  60. Petrelli NJ, Valle AA, Weber TK, Rodriguez-Bigas M: Adenosquamous adenocarcinoma of the colon and rectum. Dis Colon Rectum. 1996, 39: 1265-1268. 10.1007/BF02055120.View ArticlePubMedGoogle Scholar
  61. Martinez-Gonzalez MD, Takahashi T, Leon-Rodriguez E, Gamboa-Dominguez A, Lome C, Garcia-Blanco MC, Bezaury P, Moran MA: Case report of primary squamous carcinoma of the rectum. Rev Invest Clin. 1996, 48: 453-456.PubMedGoogle Scholar
  62. Juturi JV, Francis B, Koontz PW, Wilkes JD: Squamous-cell carcinoma of the colon responsive to combination chemotherapy: report of two cases and review of the literature. Dis Colon Rectum. 1999, 42: 102-109. 10.1007/BF02235191.View ArticlePubMedGoogle Scholar
  63. Kim JH, Moon WS, Kang MJ, Park MJ, Lee DG: Sarcomatoid carcinoma of the colon: a case report. J Korean. Med Sci. 2001, 16: 657-660.Google Scholar
  64. Copur S, Ledakis P, Novinski D, Mleczko KL, Frankforter S, Bolton M, Fruehling RM, VanWie E, Norvell M, Muhvic J: Squamous cell carcinoma of the colon with an elevated serum squamous cell carcinoma antigen responding to combination chemotherapy. Clin Colorectal Cancer. 2001, 1: 55-58. 10.3816/CCC.2001.n.006.View ArticlePubMedGoogle Scholar
  65. Sotlar K, Köveker G, Aepinus C, Selinka HC, Kandolf R, Bültmann B: Human papillomavirus type 16-associated primary squamous cell carcinoma of the rectum. Gastroenterology. 2001, 120: 988-994. 10.1053/gast.2001.22523.View ArticlePubMedGoogle Scholar
  66. Frizelle FA, Hobday KS, Batts KP, Nelson H: Adenosquamous and squamous carcinoma of the colon and upper rectum: a clinical and histopathologic study. Dis Colon Rectum. 2001, 44: 341-346. 10.1007/BF02234730.View ArticlePubMedGoogle Scholar
  67. Kim N, Luchs JS, Halpern D, Davis E, Donovan V, Weston SR, Katz DS: Radiology-pathology conference: carcinosarcoma of the colon. J Clin Imag. 2005, 29: 259-262. 10.1016/j.clinimag.2004.09.002.View ArticleGoogle Scholar
  68. Lam AK, Ho YH: Primary squamous cell carcinoma of the rectum in a patient on immunosuppressive therapy. Pathology. 2006, 38: 74-76. 10.1080/00313020500467113.View ArticlePubMedGoogle Scholar
  69. Ambrosini-Spaltro A, Salvi F, Betts CM, Frezza GP, Piemontese A, Del Prete P, Baldoni C, Foschini MP, Viale G: Oncocytic modifications in rectal adenocarcinomas after radio and chemotherapy. Virchows Arch. 2006, 448: 442-448. 10.1007/s00428-005-0137-6.View ArticlePubMedGoogle Scholar
  70. Pikarsky AJ, Belin B, Efron J, Woodhouse S, Weiss EG, Wexner SD, Nogueras JJ: Squamous cell carcinoma of the rectum in ulcerative colitis: case report and review of the literature. Int J Colorectal Dis. 2007, 22: 445-447. 10.1007/s00384-006-0110-0.View ArticlePubMedGoogle Scholar
  71. Cheng H, Sitrin MD, Satchidanand SK, Novak JM: Colonic squamous cell carcinoma in ulcerative colitis: Report of a case and review of the literature. Can J Gastroenterol. 2007, 21: 47-50.View ArticlePubMedPubMed CentralGoogle Scholar
  72. Kong CS, Welton ML, Longacre TA: Role of human papillomavirus in squamous cell metaplasia-dysplasiacarcinoma of the rectum. Am J Surg Pathol. 2007, 31: 919-925. 10.1097/01.pas.0000213441.86030.fc.View ArticlePubMedGoogle Scholar
  73. Clark J, Cleator S, Goldin R, Lowdell C, Darzi A, Ziprin P: Treatment of primary rectal squamous cell carcinoma by primary chemoradiotherapy: should surgery still be considered a standard of care?. Eur J Cancer. 2008, 44: 2340-2343. 10.1016/j.ejca.2008.07.004.View ArticlePubMedGoogle Scholar
  74. Rasheed S, Yap T, Zia A, McDonald PJ, Glynne-Jones R: Chemo-radiotherapy: an alternative to surgery for squamous cell carcinoma of the rectum--report of six patients and literature review. Colorectal Dis. 2009, 11: 191-197. 10.1111/j.1463-1318.2008.01560.x.View ArticlePubMedGoogle Scholar

Copyright

© Sameer et al; licensee BioMed Central Ltd. 2010

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<url>http://creativecommons.org/licenses/by/2.0</url>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.