Sanchez-Cordero Milaris M, Rivera Troia Felix, Ocasio Villa Fernando J
Internal Medicine, Mayaguez Medical Center, Mayaguez, PRI.
Surgery, University of Medicine & Health Science, Bassettiere, KNA.
Cureus. 2024 Sep 20;16(9):e69826. doi: 10.7759/cureus.69826. eCollection 2024 Sep.
We present the case of a 69-year-old man with squamous cell carcinoma (SCC) of the duodenum, which was identified as a metastatic lesion stemming from recurrent head and neck cancer (HNC). The patient, who had a history of hypertension, came to the emergency department with burning abdominal pain that had persisted for a week. He reported being well until he suddenly experienced lower abdominal pain, accompanied by reduced appetite, nausea, and post-meal vomiting. An abdominal CT scan revealed a high-grade mechanical obstruction of the small bowel, with a transition point in the right lower quadrant. A biopsy confirmed that the mass was a moderately differentiated metastatic keratinizing squamous cell carcinoma. Metastasis of head and neck squamous cell carcinoma (HNSCC) to the duodenum is rare, likely due to the unique anatomy of the area, which lacks significant lymphatic drainage. This case brings to our attention the need to consider atypical metastatic sites in patients with HNSCC and highlights the importance of advanced imaging and immunotherapy in the diagnosis and management of such metastases.
我们报告了一例69岁男性十二指肠鳞状细胞癌（SCC）病例，该病例被确定为复发性头颈癌（HNC）转移所致。该患者有高血压病史，因持续一周的腹部灼痛前往急诊科。他自述此前身体状况良好，直到突然出现下腹部疼痛，并伴有食欲减退、恶心和餐后呕吐。腹部CT扫描显示小肠高度机械性梗阻，梗阻转折点位于右下腹。活检证实肿块为中度分化的转移性角化鳞状细胞癌。头颈部鳞状细胞癌（HNSCC）转移至十二指肠较为罕见，可能是由于该区域独特的解剖结构，缺乏明显的淋巴引流。该病例提醒我们，对于HNSCC患者需要考虑非典型转移部位，并强调了先进成像和免疫疗法在这类转移瘤诊断和治疗中的重要性。
