INTRODUCTION Squamous cell carcinomas of the rectum are extremely rare and their pathogenesis is still under debate. Their proper diagnosis and treatment may thus be challenging. CASE PRESENTATION A 52-year-old Caucasian woman was transferred to our department with a history of pelvic pain. Colonoscopy revealed a small tumorous lesion of the upper rectum and an endoscopic biopsy showed infiltration of the rectal mucosa by a squamous cell carcinoma. Afterward, tumorous lesions were found on imaging in both her ovaries. A laparoscopy with adnexectomy and anal mapping was performed and revealed tumor masses of squamous cell carcinoma in both ovaries. Based on the large size of the ovarian tumors and the concurrence of extensive, partly ciliated, macrocystic epithelium in one of the ovaries, a diagnosis of ovarian squamous cell carcinoma arising from a mature teratoma was rendered. However, human papillomavirus genotyping analyses were positive for human papillomavirus-16 in both the rectal tumor and ovarian tumors leading to a final diagnosis of a human papillomavirus-associated rectal squamous cell carcinoma metastatic to both ovaries. Neoadjuvant chemoradiation therapy of her rectum, total mesorectal excision, and hysterectomy were performed followed by adjuvant chemotherapy. CONCLUSION Colorectal squamous cell carcinoma is a rare disease. In cases of colorectal squamous cell carcinoma, metastatic disease at any other location has to be excluded. Human papillomavirus genotyping is essential in this context. Discussion of the treatment strategies should be interdisciplinary and include chemoradiation therapy and radical surgery.

中文翻译：

---

具有诊断挑战性的人类乳头瘤病毒相关的直肠原发性鳞状细胞癌在两个卵巢都有转移：一例病例报告。

引言直肠鳞状细胞癌极为罕见，其发病机理仍在争论中。因此，对其进行正确的诊断和治疗可能具有挑战性。病例介绍一名52岁的白人妇女因骨盆疼痛的病史被转移到我们科室。结肠镜检查显示上直肠有一个小的肿瘤病变，内镜活检显示鳞状细胞癌浸润了直肠粘膜。之后，在她的两个卵巢中通过成像发现了肿瘤病变。腹腔镜与附件切除术和肛门作图进行，并揭示了两个卵巢中鳞状细胞癌的肿瘤块。根据卵巢肿瘤的大尺寸和其中一个卵巢同时出现大量，部分有纤毛的大囊上皮的情况，诊断出了由成熟畸胎瘤引起的卵巢鳞状细胞癌。然而，人类乳头瘤病毒基因分型分析在直肠肿瘤和卵巢肿瘤中对人类乳头瘤病毒16均呈阳性，从而最终诊断出人类乳头瘤病毒相关的直肠鳞状细胞癌转移至两个卵巢。对其直肠进行新辅助化学放疗，全直肠系膜切除和子宫切除术，然后进行辅助化疗。结论大肠鳞状细胞癌是一种罕见的疾病。如果是大肠鳞状细胞癌，则必须排除其他任何部位的转移性疾病。在这种情况下，人类乳头瘤病毒的基因分型至关重要。治疗策略的讨论应该是跨学科的，包括化学放射疗法和根治性手术。