Ten years and counting: Survival in stage IV metastatic squamous cell carcinoma of anal canal following radical treatment.

A 60-year-old male ptient presented with a 2-month history of altered bowel habits and occasional bleeding per rectum. On evaluation, he was diagnosed with squamous cell carcinoma of the anal canal (SCCAC) with an isolated hepatic lesion in segment II estimated as 4.3 cm × 3.5 cm on ultrasound. Subsequent needle biopsy confirmed metastatic squamous cell carcinoma deposits. The final diagnosis was SCCAC, cT4N1M1 (Stage IV). The patient was offered radical intent treatment. As per institutional protocol, the patient received two cycles of induction cisplatin + 5fluorouracil (FU) followed by chemo-radiation. 5FU and mitomycin C was given concurrently with irradiation. The primary and metastatic sites were irradiated using 6 MV photons on helical tomotherapy using conventional fractionation. Fluorodeoxyglucose positron emission tomograph-computed tomography performed 4 months after treatment completion showed a complete metabolic and morphological response. As of the date of writing, the patient is alive and disease free, 10 years after treatment with no long term sequelae.