Department of Otolaryngology, Queens University, Kinston, Ontario, Canada.
J Otolaryngol Head Neck Surg. 2014 Jun 25;43(1):18. doi: 10.1186/1916-0216-43-18.
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.
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.
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.
Metastasis of laryngeal SCC to the small bowel with perforation is exceedingly rare, but possible. These patients may be successfully managed with resection.
喉鳞状细胞癌（SCC）转移至腹腔胃肠道极为罕见。本病例报告的目的是描述一例喉 SCC 穿孔转移至回肠的病例，并复习相关的其他类似病例文献。
回顾患者病历，并复习涉及喉恶性 SCC 转移至小肠的英文文献。
我们描述了一例 58 岁男性患者的病例，该患者因 T4N2c 喉 SCC 而行诱导化疗失败，并接受了喉咽切除术、双侧颈清扫术和胸大肌皮瓣转移术。随后，患者接受了术后放疗和西妥昔单抗治疗。该患者随后出现与阑尾破裂一致的症状，超声影像支持这一诊断。患者被送往手术室，行右半结肠切除术。病理大体检查证实回肠末端有 4cm 穿透性穿孔。显微镜检查显示周围平滑肌有转移性鳞状细胞癌的沉积。在腹壁的另一个结节中也发现了转移性癌。患者术后恢复顺利，此后存活了数月。
喉 SCC 转移至小肠并穿孔极为罕见，但可能发生。这些患者可通过切除成功治疗。
