Successful treatment of rectal cancer complicated by bladder invasion, peritumorally abscess, and a fistula in the anterior abdominal wall (case report)

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Abstract

This article reports the experience of treating a case of rectal cancer complicated by peritumorally abscess and intestinal fistulas in the anterior abdominal wall. Despite infectious complications, the patient underwent all stages of comprehensive treatment, including neoadjuvant chemoradiotherapy, consolidation polychemotherapy, and surgery. After sigmostomy with a course of antibacterial therapy, the patient received one cycle of external beam radiotherapy plus capecitabine followed by one full and one partial cycle of consolidating polychemotherapy (CapOx). Afterwards, the patient underwent R0 total mesorectal excision. No disease progression was observed during the next two years. Thus, complicated cancer require additional therapy; however, it should not be considered as a contraindication for combination treatment or as a reason for changing its order recommended in clinical guidelines.

About the authors

V. A. Ivanov

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Author for correspondence.
Email: dr.valeryivanov@gmail.com
ORCID iD: 0000-0003-3028-7578

24 Kashirskoe Shosse, Moscow 115478.

Russian Federation

S. S. Gordeev

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: fake@neicon.ru
ORCID iD: 0000-0002-9303-8379

24 Kashirskoe Shosse, Moscow 115478.

Russian Federation

S. I. Tkachev

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: fake@neicon.ru
ORCID iD: 0000-0001-8965-8172

24 Kashirskoe Shosse, Moscow 115478.

Russian Federation

A. G. Perevoshchikov

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: fake@neicon.ru

24 Kashirskoe Shosse, Moscow 115478.

Russian Federation

References

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  3. Kitahara T., Uemura M., Haraguchi N. et al. Successful treatment of rectal cancer with perineal invasion: three case reports. Mol Clin Oncol 2014;2(4):497—500. PMID: 24940483. doi: 10.3892/mco.2014.282.
  4. Benjelloun el B., Aitalalim S., Chbani L. et al. Rectosigmoid adenocarcinoma re-vealed by metastatic anal fistula. The visible part of the iceberg: a report of two cases with literature review. World J Surg Oncol 2012;10:209. PMID: 23033985. doi: 10.1186/1477-7819-10-209.
  5. Glynne-Jones R., Wyrwicz L., Tiret E. et al. Rectal cancer: ESMO Clinical Prac-tice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2017;28 (Suppl 4):iv22—40. PMID: 28881920. doi: 10.1093/annonc/mdx224.
  6. Ananyev V.S., Artamonova E.V., Achkasov S.I. et al. Clinical guidelines: rectal Cancer. 2017. Available at: http://oncology-association.ru/files/clinical-guidelines_adults/rak_pryamoy_kishki.pdf. (In Russ.).

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