Cecília Araújo  Carneiro Lima,Juliana Karine  Ferreira Santos Lessa,Luciana Mata  da Silva,Mário Rino Martins,Rogério Luiz  dos Santos,
Management of Para-Aortic Lymph Node Metastasis in Rectal Squamous Carcinoma
Surgery Case Reports
2020
2733-225X
http://dx.doi.org/10.31487/j.JSCR.2020.03.06
https://www.sciencerepository.org/management-of-para-aortic-lymph-node-metastasis-in-rectal-squamous_JSCR-2020-3-106 
Abstract: 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).Keywords: Squamous carcinoma, rectal neoplasm, para-aortic, metastasis