EC Cancer

Squamous cell carcinomas represent 30% of skin carcinomas. Perianal localization is rare and should be investigated for HPV infection, a history of pilonidal cyst and visceral metastasis which remains exceptional. We report two cases of squamous cell carcinoma located at the intergluteal fold in two patients. The first patient had already been operated on for a pilonidal cyst, the squamous cell carcinoma was classified as T2N0M0 and the patient underwent tumor resection without recurrence and whose exploration revealed a benign renal tumor. The second patient had no medical history and she also had a squamous cell carcinoma classified as T2N0M0 for which she was operated.

Clinically, perianal squamous cell carcinoma initially presents as an erythematous or flesh-colored nodule on eczematized skin. The tumor extends laterally and in depth to have a vegetative, exophytic "cauliflower" appearance; it may eventually ulcerate. Functional signs include pruritus, discharge, bleeding and pain. A diagnostic delay was estimated in 33% of cases and this following a wrong diagnosis such as eczema, lichen therefore any lesion not responding to conservative treatment should be biopsied. Well-differentiated perianal lesions, without sphincter involvement and non-metastatic (T1T1, N0, M0) are excised locally with wide margins of 1cm. Chemoradiotherapy is indicated for locally advanced tumours, with lymph node involvement or sphincter muscle invasion, while abdomino-perineal resection is reserved for large tumors.

Keywords: Squamous Cell; Carcinoma; Gluteal Fold; Perianal; Surgery

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