Squamous cell carcinoma of the rectum is a rare malignancy that has been associated with chronic inflammation and infection ¹. This case involves a very large, locally advanced rectal/anal cancer that is clinically classified as cT4bN2Mx and, at a minimum, corresponds to AJCC stage IIIC rectal squamous cell carcinoma. The tumor exhibits moderate to poor differentiation and has squamous cell histology. It is located within 1 cm of the anal verge, as observed during the colonoscopy. The tumor has extended to the bladder and pelvic sidewall, rendering it inoperable. Surprisingly, the pathology reveals squamous cell carcinoma (SCC). Consequently, the patient's only treatment option is a combination of radiation therapy with palliative intent.

Co-author: Hashem Elessawy, DO