# Fournier’s gangrene as initial presentation of rectal cancer

## TL;DR

A 47-year-old man presented with Fournier’s gangrene, which was later found to be the first sign of early-stage rectal cancer.

## Contribution

This case highlights the rare presentation of rectal cancer as Fournier’s gangrene in a young patient with an early pathological stage.

## Key findings

- Fournier’s gangrene can be the initial manifestation of rectal cancer in young patients.
- Despite severe clinical presentation, the cancer was diagnosed at an early stage (pT2N0).
- Early multidisciplinary evaluation is crucial in such cases for better outcomes.

## Abstract

Fournier’s gangrene is a necrotizing fasciitis of the perineum that can occur due to a loss of integrity of the gastrointestinal or urethral mucosa. Its appearance as the debut of a perforated rectal neoplasm is unusual, more uncommon in young patients, leading to an advanced stage of the disease. Therefore, we present the case of a 47-year-old male with Fournier’s gangrene as the debut of a rectal cancer that, despite severe presentation, the pathological stage was early (pT2N0), highlighting the importance of considering neoplastic etiology in perineal gangrene and the need for an early multidisciplinary approach.