Houry Younes, Taghouan Anas, Rais Hamza, El Omri Ghassane, Rachid Moussaab, Jaouad Mohamed Reda Cherkaoui, Heddat Abdeljalil
Department of Urology, Cheikh Khalifa International University Hospital, Mohammed VI University of Sciences and Health (UM6SS), Casablanca, Morocco.
Department of Urology, Cheikh Khalifa International University Hospital, Mohammed VI University of Sciences and Health (UM6SS), Casablanca, Morocco.
Int J Surg Case Rep. 2024 Sep;122:110169. doi: 10.1016/j.ijscr.2024.110169. Epub 2024 Aug 13.
Cancers of unknown primary origin (CUP) pose a significant clinical challenge, representing a small percentage (1 to 5 %) of overall cancer cases. The patient is a 31-year-old male who has been diagnosed with poorly differentiated infiltrating squamous cell carcinoma, which has been classified as CUP. The exceptional perineal presentation and diagnostic process serve as a reminder of the diverse nature of CUPs and the crucial role played by advanced imaging methods and a multidisciplinary approach. The inclusion of this case, the seventh one in the literature, deepens our understanding of CUPs.
A 31-year-old man came in with a gradual onset of perineal pain that had been worsening for the past six months. A nodular lesion in the urogenital triangle, infiltrating the bulbo spongiosus muscle, was surgically removed. The histopathology results confirmed a poorly differentiated squamous cell carcinoma. Despite conducting extensive examinations, the multidisciplinary team was unable to determine the source of the tumour, classifying it as CUP. One year post-surgery, the patient remains in complete remission.
The management of CUPs can be challenging because of the variety of their origins and presentations. The importance of advanced imaging, pathological and biological techniques, as well as meticulous surgical intervention, is emphasized in this case, as it helps in avoiding unnecessary adjuvant therapies.
This case highlights the significance of a customized and interdisciplinary approach in effectively managing CUPs, especially when they present in unusual ways. Timely surgical intervention, backed by comprehensive imaging and pathological analysis, can result in positive results.
原发灶不明的癌症（CUP）是一项重大的临床挑战，在所有癌症病例中占比很小（1%至5%）。该患者为一名31岁男性，被诊断为低分化浸润性鳞状细胞癌，归类为CUP。这种特殊的会阴表现及诊断过程提醒我们CUP具有多样性，以及先进成像方法和多学科方法所起的关键作用。此病例是文献中的第七例，加深了我们对CUP的理解。
一名31岁男性因会阴疼痛逐渐加重前来就诊，疼痛在过去六个月持续恶化。泌尿生殖三角区的一个结节性病变，浸润球海绵体肌，已通过手术切除。组织病理学结果证实为低分化鳞状细胞癌。尽管进行了广泛检查，多学科团队仍无法确定肿瘤来源，将其归类为CUP。术后一年，患者仍处于完全缓解状态。
由于CUP起源和表现形式多样，其管理具有挑战性。本病例强调了先进成像、病理和生物学技术以及细致手术干预的重要性，因为这有助于避免不必要的辅助治疗。
本病例突出了定制化和跨学科方法在有效管理CUP中的重要性，尤其是当它们以不寻常方式出现时。在全面的成像和病理分析支持下及时进行手术干预，可取得积极效果。
