More Than Just an Abscess: An Unusual Case of Anal Squamous Cell Carcinoma

Anal squamous cell carcinoma remains a rare malignancy of the lower gastrointestinal tract. We report a 39-year-old woman who presented with recurrent perianal abscesses initially suspected to be from fistulizing Crohn's disease. Despite appropriate antibiotics and drainage, her symptoms persisted. Multiple endoscopic evaluations were performed, with initial biopsies showing only chronic inflammation. Repeat sigmoidoscopy ultimately revealed moderately differentiated squamous cell carcinoma. The patient underwent a diverting colostomy for symptom relief and was treated with chemoradiation, resulting in significant tumor reduction. This case highlights the importance of considering malignancy in patients with persistent perianal disease, particularly when inflammatory bowel disease has been ruled out.