Metastatic Squamous Cell Carcinoma of Colon Presenting as a Parietal Abscess

Abstract

Metastatic squamous cell carcinoma of the gastrointestinal tract is relatively uncommon. It is associated with a poor prognosis and behaves more aggressively. We report a case of metastatic growth in the ascending flexure of the colon that had eroded into the anterior abdominal wall muscles and resulted in a large parietal abscess. She had undergone radical hysterectomy followed by radiation therapy for stage II carcinoma of the uterine cervix 14 months back. Ultrasound guided drainage of the abscess was done as an emergency procedure to control the sepsis. After 3 days an extended Right Hemicolectomy with stapled ileo colic anastomosis was done with resection of a part of abdominal wall adherent to the growth with a grossly normal margin. Histopathological examination confirmed metastatic squamous cell carcinoma. She is disease free 2 months after surgery. Surgical management of the metastatic tumour was palliative but necessary to prevent intestinal obstruction in future.

A case report of an unusual caecal metastatic location of a primary cervical squamous cell carcinoma

“…The literature regarding these tumors is limited, with most articles being solitary case reports. In the past three decades, a total of nine cases of metastatic carcinoma cervix to the colon have been reported [ 2–6 ].…”

“…Haematochezia and abdominal pains, as well as non-specific symptoms such as abdominal distension, and vomiting, are common clinical features. Sometimes, the diagnosis is made at the stage of complications, with symptoms suggestive of bowel obstruction or perforation leading to peritonitis [ 2 , 7 ].…”

“…The prognosis of the disease is poor with the overall survival is less than a year [ 1 , 2 , 5 ]. Early detection with prompt intervention is the key factor required in the successful management of these tumors and to improve the overall survival of the patient.…”

“…In patients with advanced SCC of the uterine cervix treated by radiation, 9–27% may develop distant metastasis [ 1 ]. Usually, the disease progress through metastasis within the first two years of treatment and is associated with an overall poor prognosis [ 2 ]. Surgical resection is the main therapeutic modality, while the role of chemotherapy and radiotherapy remain ambiguous [ 3 ].…”

Squamous cell carcinoma of cervix origin with rare metastasis to the colon

“…Rare sites include the brain, skin, spleen, and muscle. Metastasis to the gastrointestinal tract is extremely uncommon (3)(4)(5)(6)(7).…”