In 2008, she was diagnosed with rectal adenocarcinoma (pT3N0M0) and villous adenoma at 11 and 4 cm from the anal margin, respectively.
Short-cycle radiotherapy was applied (25 Gypsies of 5 Gy daily) and surgery was performed: anterior rectal resection plus transanal adenoma resection.
During follow-up, a positron emission tomography (2011) was performed, identifying a left adrenal nodule and another in the surgical bed of nephrectomy, suggesting locoregional recurrence of renal carcinoma.
Lopinavir is started at a dose of 50 mg/day for 4 weeks with a 2-week rest between cycles.
After 7 cycles of treatment the patient has a complete response confirmed by a non-pelvic fracture scan.
Seven days after the number cycle thirteen the patient comes to the emergency room for pain, anal tumor and fever.
abscess is located in the right fluctuating and crepitant glue, and a wide orifice of approximately 1 cm to 5-6 cm from the left anal margin is observed in the rectal wall.
A communication of the intrarectal lumen with perirectal fat is described in the nonpelvic junction, as well as arthritis in the greater glue.
The suspicion of rectal perforation associated with necrotizing fasciitis was decided urgent surgery.
An incision is made in the floating area, leaving fecaloid content.
There is an accessory pathway that communicates with the right posterior face of the rectum.
A counter-incision is performed and a drainage is placed.
The anatomopathological study of the perforation orifice and surrounding areas showed inflammatory tissue with no evidence of malignancy.
