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Locally advanced adenocarcinoma of the rectum presenting with necrotising fasciitis of the perineum: successful management with early aggressive surgery and multimodal therapy
  1. Luís Ferreira1,
  2. Henrique Alexandrino1,2,
  3. Júlio Soares Leite1,3,
  4. Francisco Castro Sousa1,3
  1. 1Department of Surgery A, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  2. 2Faculty of Medicine, Clinica Universitária Cirurgia III, University of Coimbra, Coimbra, Portugal
  3. 3Faculty of Medicine, University of Coimbra, Coimbra, Portugal
  1. Correspondence to Dr Luís Ferreira, luisferreira82{at}


Colorectal cancer is a common malignant neoplasm and its treatment usually involves surgery associated, in some cases, depending on the staging, with chemoradiotherapy. Necrotising fasciitis of the perineum is a highly lethal infection of the perineum, perirectal tissues and genitals, requiring emergency surgical debridement, broad-spectrum antibiotics and control of sepsis. We present the case of a 59-year-old man with necrotising fasciitis of the perineum as the first clinical manifestation of locally advanced adenocarcinoma of the rectum, in which successful management consisted of early and aggressive surgical debridement, followed by multimodal therapy with curative intent. 2 years and 6 months after surgery the patient is well, with no evidence of local or systemic relapse.

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