title: Aggressive treatment of metastatic squamous cell carcinoma of the rectum to the liver: a case report and a brief review of the literature.
abstract: BACKGROUND
  Rectal squamous cell carcinoma (SCC) is a rare tumor. The incidence of this malignancy has been reported to be 0.25 to 1 per 1000 colorectal carcinomas. From a review of the English literature 55 cases of SCC of the rectum have been published. In this study we report a rectal metastatic SCC to the liver, discussing the efficacy of aggressive adjuvant and neo-adjuvant therapies on survival and prognosis.
  
  
  METHODS
  A 39-year-old female patient with a pure SCC of the rectum diagnosed endoscopically is presented. The patient underwent initially neoadjuvant chemo-radiotherapy and then abdominoperineal resection with concomitant bilateral oophorectomy and hysterectomy, followed by adjuvant chemo-radiotherapy. Five months after the initial operation liver metastasis was demonstrated and a liver resection was carried out, followed by adjuvant chemotherapy. Eighteen months after the initial operation the patient is alive.
  
  
  CONCLUSIONS
  Although prognosis of rectal SCC is worse than that of adenocarcinoma, an aggressive therapeutic approach with surgery as the primary treatment, followed by combined neo- and adjuvant chemo-radiotherapy, may be necessary in order to improve survival and prognosis.
authors.affiliation: Second Department of Surgery, Areteion University Hospital, Athens Medical School, University of Athens, 76 Vasilisis Sofias av, 11528, Athens, Greece. theodosios@panafonet.gr
authors.forename: Theodosios K
authors.initials: TK
authors.lastname: Theodosopoulos
authors.forename: Athanasios D
authors.initials: AD
authors.lastname: Marinis
authors.forename: Nikolaos A
authors.initials: NA
authors.lastname: Dafnios
authors.forename: John G
authors.initials: JG
authors.lastname: Vassiliou
authors.forename: Lazaros D
authors.initials: LD
authors.lastname: Samanides
authors.forename: Eleni E
authors.initials: EE
authors.lastname: Carvounis
authors.forename: Vassilios E
authors.initials: VE
authors.lastname: Smyrniotis