Mandadi Srujana Reddy, Kudva Annappa
Department of General Surgery, Kasturba Medical College Manipal University, Manipal, India.
Int J Surg Case Rep. 2018;51:178-180. doi: 10.1016/j.ijscr.2018.07.036. Epub 2018 Aug 9.
Cutaneous metastasis from head and neck cancer is uncommon and it is seen from laryngeal cancer. Acrocutaneous metastasis from the base of tongue is relatively rare.
We present a case of a 84-year-old male, previously diagnosed to have moderately differentiated squamous carcinoma of the base of tongue with lung and liver metastases and received palliative chemoradiation. He, now presented with ulcero-proliferative growth over the right 5th finger. In the present case, the patient initially presented with a nodule which later ulcerated and increased in size. There was associated discharge. There was clinical suspicion of underlying osteomyelitis. Hence right 5th finger amputation upto the middle phalanx was done. The histopathology report of the specimen was moderately differentiated squamous cell carcinoma. This is a case of skin metastasis from squamous carcinoma of the base of Tongue is rare at a short span of time following the completion of treatment. This case has highlighted the probable presence of occult skin metastasis at the time of diagnosis, which became apparent after the completion of treatment.
Fine needle aspiration cytology should be done in cutaneous nodules associated with head and neck cancers to rule out malignancy, even if it clinically appears to be benign in nature.
头颈部癌的皮肤转移并不常见，喉癌可见此类情况。舌根部的皮肤转移相对罕见。
我们报告一例84岁男性患者，此前诊断为舌根部中度分化鳞状细胞癌伴肺和肝转移，并接受了姑息性放化疗。他现在右手小指出现溃疡增殖性肿物。在本病例中，患者最初表现为一个结节，随后溃疡且增大，伴有分泌物。临床怀疑有潜在骨髓炎。因此，对右手小指进行了截指，截指至中节指骨。标本的组织病理学报告为中度分化鳞状细胞癌。这是一例舌根部鳞状细胞癌在治疗结束后短时间内发生皮肤转移的病例，较为罕见。该病例凸显了在诊断时可能存在隐匿性皮肤转移，在治疗结束后才变得明显。
对于与头颈部癌相关的皮肤结节，即使临床外观看似良性，也应进行细针穿刺细胞学检查以排除恶性肿瘤。
