title: Successful treatment of rectal cancer with perineal invasion: Three case reports.
abstract: Rectal cancer occasionally invades adjacent organs. However, rectal cancer with perineal invasion is uncommon and difficult to treat. Locally advanced colorectal cancer may be clinically treated with neoadjuvant therapy, followed by en bloc resection. Skin invasion may lead to tumor dissemination via cutaneous blood flow and lymphatic routes. There is currently no firm evidence regarding the treatment of these significantly advanced rectal cancers. In this study, we report 3 cases of rectal cancer with perineal invasion, successfully managed by multimodality treatment. Case 1 is a 52-year-old man with rectal cancer that had invaded the perineum; case 2 is a 38-year-old man with rectal cancer infiltrating the perineal skin and liver metastasis; and case 3 is a 50-year-old woman with rectal cancer and perineal invasion. All the cases were treated with radical excision. No severe complications were observed in the perioperative period. Case 2, in particular, was confirmed to remain alive 5 years after the surgery. Our experience suggests that multimodality treatment, including extended radical surgery, may be a feasible approach to the treatment of rectal cancer with perineal skin invasion.
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka 565-0871, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kitahara
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka 565-0871, Japan.
authors.forename: Mamoru
authors.initials: M
authors.lastname: Uemura
authors.affiliation: Department of Gastroenterological Surgery, National Hospital Organization, Osaka National Hospital, Osaka, Osaka 540-0006, Japan.
authors.forename: Naotsugu
authors.initials: N
authors.lastname: Haraguchi
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka 565-0871, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Nishimura
authors.affiliation: Department of Surgery, Saiseikai Senri Hospital, Suita, Osaka 565-0862, Japan.
authors.forename: Tatsushi
authors.initials: T
authors.lastname: Shingai
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka 565-0871, Japan.
authors.forename: Taishi
authors.initials: T
authors.lastname: Hata
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka 565-0871, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Takemasa
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka 565-0871, Japan.
authors.forename: Tsunekazu
authors.initials: T
authors.lastname: Mizushima
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka 565-0871, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka 565-0871, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka 565-0871, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Yamamoto
keywords: extended radical surgery; multimodality treatment; perineal invasion; rectal cancer