Rectal Adenocarcinoma and Keratinizing Squamous Cell Carcinoma of the Vulva: Report of a Rare Case

Introduction Vulvar cancer is a rare oncological condition, accounting for only 0.8% of all cancers. In contrast, colorectal cancer is a more common malignancy, ranking as the third most prevalent cancer worldwide. These two pathologies, when occurring simultaneously as distinct tumor types, are exceptionally rare. Case Presentation A 76-year-old female presented with complaints of rectal bleeding during defecation. Patient was evaluated on an outpatient basis for vulvar carcinoma. Biopsy findings revealed keratinizing squamous cell carcinoma G1. A CT scan of the chest, abdomen, and pelvis showed tumor-like masses in the pelvic region involving labia minora, vagina, rectum, also pathological lymph nodes in the inguinal region were found. For further assessment, MRI was performed, in the middle third of the rectum a tumor was identified. A biopsy of the rectal tumor showed adenocarcinoma. The patient underwent surgery via a laparotomy incision. An obstructive rectal resection was performed, with the formation of a colostomy on the left abdominal side. Vulvar resection and excision of pathological lymph nodes were also performed. Observing good clinical recovery, the patient was discharged home 12 days postoperatively, with a planned third-stage rehabilitation program in a sanatorium. Discussion Concurrent rectal adenocarcinoma and vulvar keratinizing squamous cell carcinoma as independent primary tumours is an exceptionally rare presentation requiring multimodal management.Treatment strategies for both malignancies depend on location, tumour size and lymph node involvement. Management typically involves a combination of surgical intervention and radiation therapy. In cases of rectal cancer, chemotherapy may also be administered depending on the extent of the disease. Conclusions Although rectal adenocarcinoma is a more common malignancy, its simultaneous occurrence with vulvar squamous cell carcinoma is exceedingly rare. Early diagnosis, multidisciplinary evaluation, and timely management are crucial for improving patient outcomes in such complex oncological cases.