TY - JOUR
AR - JSCR-2020-3-106
TI - Management of Para-Aortic Lymph Node Metastasis in Rectal Squamous Carcinoma
AU - Cecília Araújo , Carneiro Lima
AU - Juliana Karine , Ferreira Santos Lessa
AU - Luciana Mata , da Silva
AU - Mário Rino, Martins
AU - Rogério Luiz , dos Santos
JO - Surgery Case Reports
PY - 2020
DA - Fri 19, Jun 2020
SN - 2733-225X
DO - http://dx.doi.org/10.31487/j.JSCR.2020.03.06
UR - https://www.sciencerepository.org/management-of-para-aortic-lymph-node-metastasis-in-rectal-squamous_JSCR-2020-3-106 
KW - Squamous carcinoma, rectal neoplasm, para-aortic, metastasis
AB - Background: Squamous cell carcinoma (SCC) of the rectum is a rare malignancy, and retroperitoneal nodal
metastasis (RNM) represent 1-2% of colorectal cancer metastasis (CRC), and radical retroperitoneal
lymphadenectomy (RRL) in this setting remains controversial. However, there are no reports in the literature
on how to treat SCC retroperitoneal lymph node metastasis.
Case Presentation: The patient was a 47-years-old woman with SCC of the rectum. Concomitant
chemoradiotherapy (CRT) followed by surgery was planned. After 8 weeks, CT of the abdomen for
restaging showed a 6 cm para-aortic mass involving and obstructing the medium third of the left ureter. The
patient was submitted to abdominoperineal rectal resection with left nephrectomy and en-bloc resection of
para-aortic tumor (nodal bulking).
Conclusion: After a thorough review of the literature regarding RNM for rectal SCC, we found no mention
of how to treat RNM for rectal SCC. The purpose of this paper is to report a very rare case of RNM for
rectal SCC and to discuss the surgical approach. Surgery seems to be the best option for local control and
improvement in overall survival (OS).