Zaw Shin T, Zaw Thinzar, Chen Ri, El-Far Ahmad
College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, USA.
College of Medicine, University of Central Florida College of Medicine, Orlando, USA.
Cureus. 2023 May 11;15(5):e38898. doi: 10.7759/cureus.38898. eCollection 2023 May.
This report describes a case involving the diagnosis and treatment of squamous cell carcinoma (SCC) of the duodenum, which was found to be a metastatic lesion originating from recurrent head and neck cancer (HNC) in a 74-year-old female patient. The patient had a past medical history of gastroesophageal reflux disease (GERD), tonsillar SCC, and recurrent HNC. She presented with symptoms of burning, tingling, and numbness of the throat and left side of the tongue. Upon examination with an esophagogastroduodenoscopy, an ulcerated hard area mass was detected in the third portion of the duodenum. Biopsy results confirmed the mass to be a metastatic poorly differentiated SCC. The incidence of head and neck squamous cell carcinoma (HNSCC) metastasis to the duodenum is rare, likely due to the unique anatomic location and the lack of lymphatic drainage in the area. The patient was treated with a combination of paclitaxel, carboplatin, and pembrolizumab. This case underscores the significance of considering unusual sites of metastasis in HNSCC patients and utilizing advanced imaging modalities and immunotherapy to detect and treat these locations effectively.
本报告描述了一例十二指肠鳞状细胞癌（SCC）的诊断和治疗病例，该病例为一名74岁女性患者，十二指肠鳞状细胞癌被发现是源自复发性头颈癌（HNC）的转移性病变。该患者既往有胃食管反流病（GERD）、扁桃体SCC和复发性HNC病史。她出现了喉咙和舌头左侧烧灼、刺痛和麻木的症状。经食管胃十二指肠镜检查，在十二指肠第三部分发现一个溃疡状硬区肿块。活检结果证实该肿块为转移性低分化SCC。头颈部鳞状细胞癌（HNSCC）转移至十二指肠的发生率很低，可能是由于该区域独特的解剖位置和缺乏淋巴引流。该患者接受了紫杉醇、卡铂和派姆单抗联合治疗。本病例强调了在HNSCC患者中考虑不寻常转移部位以及利用先进成像方式和免疫疗法有效检测和治疗这些部位的重要性。
