Quick Case: Rectal Cancer Presenting as a Perineal Abscess

A 74-year-old male presented with a painful swelling for the last 3 months, along with dyschezia, dysuria and bloody stools. The lesion measured about 4 cm in diameter, and it was tender and cystic. No discharging sinus was present. He also had bilateral multiple discrete inguinal lymph nodes. The “abscess” was drained under local anaesthesia and the “pus” was sent for routine cytological and microbiological tests.

PAP stain confirmed the diagnosis of squamous cell carcinoma. Histopathology also confirmed the diagnosis of squamous cell carcinoma of the rectum. Further tests were done for staging of the tumor, which had already spread to the liver and lungs (Stage IV). The patient is now under (palliative) chemoradiotherapy.

Learning Points/Take Home Messages

Rectal cancer may present as a perineal abscess; a tissue diagnosis might prevent an unnecessary delay in proper management!

About The Author

Dr. Samanta, MBBS, MD is currently a consultant at Suraksha diagnostic PVT. LTD. Kolkata, India for histopath, cytopath and hematology. His other interests are: oncopathology, bone marrow and neuropathology.


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