Carcinoma of the larynx, metastatic to illeum, presents as ruptured appendicitis: case report and literature review

Journal of Otolaryngology-Head & Neck Surgery

Jason H Franklin²  Neil Parry⁴  Jessica Shepherd³  David Bottoni⁴  Jordan T Glicksman¹ 

[1] Department of Otolaryngology—Head and Neck Surgery, Schulich School of Medicine, University of Western Ontario, London, Ontario, Canada;Hotel Dieu Hospital, Murray Building, Kingston, Ontario, Canada;Department of Pathology, Schulich School of Medicine, University of Western Ontario, London, Ontario, Canada;Division of General Surgery and Division of Critical Care, Schulich School of Medicine, University of Western Ontario, London, Ontario, Canada

关键词: Perforation;    Small intestine;    Metastasis;    Squamous cell carcinoma;    Larynx;   

Others  :  861303
DOI  :  10.1186/1916-0216-43-18

 received in 2014-01-13, accepted in 2014-06-05,  发布年份 2014

【 摘 要 】

Objectives

Metastasis of laryngeal squamous cell carcinoma (SCC) to the intra-abdominal gastrointestinal tract is exceedingly rare. The objectives of this case report are to describe a case involving a perforated metastasis of a laryngeal SCC to the ileum and to review the literature pertaining to other similar cases.

Methods

A review of patient’s chart and a review of the English literature involving malignant SCC of the larynx with metastasis to the small bowel.

Results

We describe the case of a 58-year-old man who had failed induction chemotherapy and underwent a laryngopharyngectomy with bilateral neck dissection and pectoralis major flap for a T4N2c laryngeal SCC. Subsequently, the patient was treated with postoperative radiation and cituximab.

The patient went on to present with symptoms consistent with a ruptured appendix, supported by ultrasound imaging. The patient was taken to the operating room where a right hemicolectomy was performed. Pathological gross examination confirmed a 4 cm transmural perforation in the terminal ileum. Microscopy demonstrated deposits of metastatic squamous cell carcinoma in the surrounding smooth muscle. Metastatic carcinoma was also found in a separate nodule from the abdominal wall. The patient had an uncomplicated post-operative period, and survived several months thereafter.

Conclusions

Metastasis of laryngeal SCC to the small bowel with perforation is exceedingly rare, but possible. These patients may be successfully managed with resection.

【 授权许可】

   
2014 Glicksman et al.; licensee BioMed Central Ltd.

【 图 表 】

【 参考文献 】

• [1]Gil Z, Fliss DM: Contemporary management of head and neck cancers. Isr Med Assoc J 2009, 11(5):296-300.
• [2]Sasaki CT, Jassin B: Cancer of the pharynx and larynx. Am J Med 2001, 111(Suppl 8A):118S-123S.
• [3]Chu EA, Kim YJ: Laryngeal cancer: diagnosis and preoperative work-up. Otolaryngol Clin North Am 2008, 41(4):673-695. v
• [4]Mehanna H, Paleri V, West CM, Nutting C: Head and neck cancer-Part 1: epidemiology, presentation, and preservation. Clin Otolaryngol 2011, 36(1):65-68. doi:10.1111/j.1749-4486.2010.02231.x
• [5]Kotwall C, Sako K, Razack MS, Rao U, Bakamjian V, Shedd DP: Metastatic patterns in squamous cell cancer of the head and neck. Am J Surg 1987, 154(4):439-442.
• [6]Coco C, Rizzo G, Manno A, Mattana C, Verbo A: Surgical treatment of small bowel neoplasms. Eur Rev Med Pharmacol Sci 2010, 14(4):327-333.
• [7]Dwivedi RC, Kazi R, Agrawal N, Chisholm E, St Rose S, Elmiyeh B, Rennie C, Pepper C, Clarke PM, Kerawala CJ, Rhys-Evans PH, Harrington KJ, Nutting CM: Comprehensive review of small bowel metastasis from head and neck squamous cell carcinoma. Oral Oncol 2010, 46(5):330-335. Epub 2010 Feb 26
• [8]BoquienY Kerneis JP, Alliot G, Dhelmeau G: Épithélioma secondaire de l’intestin grêle. Á propos de cinq observations. Presse Med 1961, 69:879-882.
• [9]Bresler L, Corroy JS, Brunet A, Vidrequin A, Aymard B, Boissen P: Métastases iléales d’un carcinome épidermo de l’épiglotte. Une observation. Presse Med 1988, 17:536-537.
• [10]Lesur G, Pelletier G, Fabre M, Vieillefond A, Buffet C: Métastaseiléale d’un cancer de l’amygdale. Gastroenterol Clin Biol 1988, 12:292-293.
• [11]François E, Santini J, Macchiavello JC, Ferrero JM, Schneider M: Métastase iléale d’un carcinome épidermo révélé par une hémorragie digestive. Presse Med 1989, 24:18.
• [12]Petiot JM, Lehur PA, Girard JY, Cuillere P, Le Borgne J: Double métastase duodénale et jéjunale d’un carcinome épidermo du larynx révélée par une double perforation. Gastroenterol Clin Biol 1991, 33:127-133.
• [13]Hamdan M, Brunet PH, Wegner J: Perforation jéjunale métastatique d’un cancer du larynx. J Chir (Paris) 1991, 128:332.
• [14]Airoldi M, Gabriele P, Succo G, Valente G, Brando V: Small bowel metastases from squamous cell carcinoma of the larynx. A casereport. Tumori 1993, 79:286-287.
• [15]Gonzales CI, Garriga SJL, Girons L, Lopez TA, Alvarez YVA: Perforacion yeyunal como manifestacion metastatica. Inicial de carcinoma laryngeo. Rev Esp Enferm Dig 1994, 85:41-44.
• [16]Yoshihara T, Yamamura Y: An unusual case of laryngeal carcinoma metastasing to the small intestine. J Laryngol Otol 1997, 111:575-577.
• [17]Büyükçelik A, Ensari A, Sarioğlu M, Işikdogan A, Içli F: Squamous cell carcinoma of the larynx metastasized to the ampulla of Vater. Report of a case. Tumori 2003, 89(2):199-201.