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Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer

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Rectal Adenocarcinoma Presenting as a Perirectal Abscess.

Bibek Saha^1,2, Jared Dang¹, Melissa Kahili-Heede¹

¹John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA.

Case Reports in Gastroenterology

|April 24, 2023

Summary

Rectal cancer can present unusually, like a perirectal abscess, especially with other symptoms. Early diagnosis and treatment, including surgery and chemoradiation, are crucial for remission.

Keywords:

Case report Fournier’s gangrene Perirectal abscess Rectal adenocarcinoma Rectal cancer

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Area of Science:

Gastroenterology
Surgical Oncology

Background:

Rectal cancer (RC) symptoms like bleeding and pain are often nonspecific and can be misdiagnosed.
Rare presentations of RC can delay diagnosis and treatment.

Observation:

A 52-year-old male with diabetes presented with symptoms mimicking a perirectal abscess and sepsis.
Initial symptoms of rectal bleeding and bowel habit changes were attributed to other causes over two years prior.

Findings:

Workup revealed rectal adenocarcinoma (pT4N0M0, stage IIB/C) presenting as a perirectal abscess.
Successful treatment involved debridement, antibiotics, neoadjuvant chemoradiation, and abdominoperineal resection.

Implications:

Rare presentations of rectal cancer, such as perirectal abscess, require high clinical suspicion.
Integrating rare presentations with conventional symptoms aids in timely rectal cancer diagnosis and management.