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Session: ePoster Monitor 6-Other Neoplasia and Education

eP441 - New Diagnosis of Squamous Cell Colon Cancer Reveals Occult Primary Malignancy

Sunday, June 2, 2024
1:39 PM – 1:44 PM ET, USA
Location: Baltimore Convention Center, Room 318-320

    ePoster Presenter(s)

  • Samantha D. Demoss, MD

    General Surgery Resident
    Rush University Medical Center
    Rush University
    Chicago, IL, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Senior Author(s)

  • MA

    Marissa L. Anderson, MD

    Surgeon
    Rush University Medical Center
    Chicago, Illinois, United States

    Disclosure information not submitted.

Purpose/Background: Squamous cell cancer of the colon is exceedingly rare, with less than 1% of colon cancer revealing this pathology. When identified, a workup to find an occult remote primary cancer should be pursued.Methods/Interventions: Our patient is an 83 year old female who presented with three months of abdominal pain, nausea and emesis. A CT scan demonstrated a colonic stricture near the hepatic flexure. Colonoscopy revealed an endoscopically obstructing stricture with surrounding congested mucosa. Biopsy results returned only with edematous tissue, no dysplasia. Given her obstruction, the decision was made to proceed with a right hemicolectomy.Results/Outcomes: The abdomen was entered via a midline incision. Small volume ascites was noted and sent for cytology. The colon was examined - hard masses were noted at the hepatic flexure and proximal transverse colon. Cytology of the ascitic fluid revealed malignant cells. Pathology from the specimen returned positive for invasive, moderately differentiated, transmural squamous cell carcinoma (strongly p16 positive) metastatic to 3/26 lymph nodes. Further workup remarkable for firm nodularity of the cervix and pap smear with CIN 2/3, +HPV.Conclusion/

Discussion: Primary squamous cell cancer of the colon is rare and most commonly the result of metastasis from an occult primary lesion. Malignant colonic strictures with squamous cell pathology require an exclusion of other primary sites such as the anus, cervix, head/neck and urinary tract to establish a diagnosis.