Xu Zhijian, Lv Jianjian, Ginat Daniel T, Trada Yuvnik, Zhou Mi
Oncology Department, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, China.
Department of Radiology, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.
Transl Cancer Res. 2025 Feb 28;14(2):1492-1499. doi: 10.21037/tcr-24-1744. Epub 2025 Jan 2.
Oropharyngeal squamous cell carcinoma (OPSCC) is a type of head and neck squamous cell carcinoma (HNSCC). The incidence of distant metastasis from HNSCC is approximately 10-15%. The most frequent organs of distant metastasis include the bone, liver, and lungs, and the occurrence of metastasis to the colon is very rare. To date, the treatment recommendation for these patients, especially local treatment, is unclear. This case reports a real case of a rare metastatic location from OPSCC, thus expanding our knowledge of OPSCC. At the same time, it suggests that local treatment has potential value in patients with metastatic HNSCC, especially for those with concomitant local symptoms.
The patient, a 72-year-old male, underwent radical radiotherapy with concurrent chemotherapy for previously diagnosed with cT4N2M0 stage III HPV16 (+) (American Joint Committee on Cancer, 8th) OPSCC. The patient experienced diarrhea during the post-treatment monitoring period and subsequently underwent a re-examination. The positron emission tomography-computed tomography (PET-CT) findings confirmed colonic metastasis and axillary lymph node enlargement. After the surgical removal of the colon tumor, OPSCC metastasis was confirmed. PET-CT findings of other organs and primary lesions did not suggest recurrence or metastasis. This case provides a new reference for the pattern of disease progression in patients with HNSCC who have received radical concurrent radiochemotherapy. This patient achieved long-term, high-quality survival as a result of local surgery, radiotherapy, systemic immune checkpoint inhibitor therapy, and anti-vascular targeted therapy. The patient's progression-free survival (PFS) has reached 28 months, and apart from bone marrow suppression induced by chemotherapy, no adverse reactions have occurred during the combination of immunotherapy and targeted therapy.
This case not only provides an example of a rare metastatic location of OPSCC, thus expanding our knowledge of OPSCC. At the same time, it suggests that local treatment has potential value in patients with metastatic HNSCC, especially for those with concomitant local symptoms.
口咽鳞状细胞癌（OPSCC）是头颈部鳞状细胞癌（HNSCC）的一种类型。HNSCC远处转移的发生率约为10%-15%。最常见的远处转移器官包括骨、肝和肺，转移至结肠的情况非常罕见。迄今为止，对于这些患者的治疗建议，尤其是局部治疗，尚不清楚。本病例报告了一例OPSCC罕见转移部位的真实病例，从而扩展了我们对OPSCC的认识。同时，这表明局部治疗在转移性HNSCC患者中具有潜在价值，尤其是对于伴有局部症状的患者。
该患者为一名72岁男性，因先前诊断为cT4N2M0 III期HPV16（+）（美国癌症联合委员会第8版）OPSCC接受了根治性放疗联合化疗。患者在治疗后监测期间出现腹泻，随后接受复查。正电子发射断层扫描-计算机断层扫描（PET-CT）结果证实结肠转移和腋窝淋巴结肿大。在手术切除结肠肿瘤后，证实为OPSCC转移。其他器官和原发灶的PET-CT结果未提示复发或转移。本病例为接受根治性同步放化疗的HNSCC患者的疾病进展模式提供了新的参考。该患者通过局部手术、放疗、全身免疫检查点抑制剂治疗和抗血管靶向治疗实现了长期、高质量生存。患者的无进展生存期（PFS）已达28个月，除化疗引起的骨髓抑制外，免疫治疗和靶向治疗联合期间未发生不良反应。
本病例不仅提供了OPSCC罕见转移部位的实例，从而扩展了我们对OPSCC的认识。同时，这表明局部治疗在转移性HNSCC患者中具有潜在价值，尤其是对于伴有局部症状的患者。
