Squamous Cell Carcinoma of the Sigmoid Colon: A Rare Late Presentation of Metastatic Urothelial Cancer with Squamous Differentiation of the Bladder

Authors

• Hamzah Shariff, MD, Thomas Jefferson University HospitalFollow
• Ghazal Ghafari, DO, MPH, Geisinger Medical Center, Danville, PA
• Zachary Hoffer, MD, PhD, Geisinger Medical Center, Danville, Pennsylvania
• Danyall Saeed, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania
• Anila Mahesh, MD, Geisinger Wyoming Valley Medical Center, Wilkes Barre, Pennsylvania
• Kishore Kumar, MD, Geisinger Wyoming Valley Medical Center, Wilkes Barre, Pennsylvania

Abstract

Urothelial cell carcinoma (UCC) with squamous differentiation (SqD) is a subtype of bladder cancer with high metastatic potential. Metastasis of muscle-invasive UCC to the GI tract, with complete transition to squamous cell carcinoma (SCC), is rare, particularly in females. We present a female patient with high grade UCC with SqD treated with radical cystectomy and immunotherapy who presented with hematochezia 1 year after her cancer treatment. Imaging and colonoscopy revealed an annular, obstructing mass in the rectosigmoid region prompting sigmoid colectomy and partial proctectomy. Histopathology revealed invasive SCC. New gastrointestinal (GI) symptoms with prior invasive bladder cancer should prompt evaluation for GI metastasis and escalation to multidisciplinary assessment for surgical resection if clinically appropriate. Clinicians should consider this rare anatomic involvement when assessing patients with previous high-grade bladder cancer and new GI symptoms.

Recommended Citation

Shariff, MD, Hamzah; Ghafari, DO, MPH, Ghazal; Hoffer, MD, PhD, Zachary; Saeed, Danyall; Mahesh, MD, Anila; and Kumar, MD, Kishore (2026) "Squamous Cell Carcinoma of the Sigmoid Colon: A Rare Late Presentation of Metastatic Urothelial Cancer with Squamous Differentiation of the Bladder," The Medicine Forum: Vol. 27, Article 20.
Available at: https://jdc.jefferson.edu/tmf/vol27/iss1/20