Ahmed Ahmed, Lenza Christopher
Internal Medicine, Rutgers University, Newark, USA.
Gastroenterology and Hepatology, Veterans Affairs Medical Center, East Orange, USA.
Cureus. 2021 Jan 22;13(1):e12859. doi: 10.7759/cureus.12859.
Metastatic disease to the duodenum or peritoneum from a primary head and neck carcinoma is an extremely rare presentation. We report the case of a 68-year-old male with a history of head and neck squamous cell carcinoma (HNSCC) who presented with worsening nausea, abdominal pain, postprandial vomiting, and early satiety for over two months. Prior to this presentation, he was evaluated for several postauricular lumps, with computerized tomography (CT) scan showing a supraglottic mass and an excisional biopsy of a postauricular nodule confirming metastatic HNSCC. A CT scan of the chest, abdomen, and pelvis during the admission showed worsening lymphadenopathy in the mediastinum and hilar regions, as well as new ascites and peritoneal lesions. Esophagogastroduodenoscopy showed a large erythematous nodular lesion in the second portion of the duodenum occupying approximately one-third of the lumen circumference. Similar to the previously worked up nodule, histology from the duodenal mass biopsies showed metastatic poorly differentiated squamous cell carcinoma that was strongly positive for p63 and p16. Thus, we report the first case of concurrent duodenal and peritoneal metastasis from an HNSCC.
原发性头颈癌转移至十二指肠或腹膜是一种极为罕见的表现。我们报告一例68岁男性，有头颈鳞状细胞癌（HNSCC）病史，出现恶心加重、腹痛、餐后呕吐和早饱超过两个月。在此表现之前，他因耳后多个肿块接受评估，计算机断层扫描（CT）显示声门上肿物，耳后结节切除活检证实为转移性HNSCC。入院时胸部、腹部和骨盆的CT扫描显示纵隔和肺门区域淋巴结病加重，以及新发腹水和腹膜病变。食管胃十二指肠镜检查显示十二指肠第二部有一个大的红斑性结节病变，占据管腔周长约三分之一。与之前检查的结节相似，十二指肠肿物活检的组织学显示为转移性低分化鳞状细胞癌，p63和p16呈强阳性。因此，我们报告首例HNSCC同时发生十二指肠和腹膜转移的病例。
