AlOmran H, AlBayyat L, AlMiman H, Boqari D, AlDuhileb M, Madkhali T. A rare cause of small bowel perforation: A metastatic lesion from squamous cell carcinoma of the tongue.
Int J Surg Case Rep 2020;
68:154-157. [PMID:
32155586 PMCID:
PMC7062934 DOI:
10.1016/j.ijscr.2020.02.011]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 02/04/2020] [Indexed: 11/04/2022] Open
Abstract
Metastasis from head and neck tumors to the gastrointestinal tract is rare.
The mechanism of metastasis in those cases is unclear due to the rarity.
Based on the existing data, prognosis is dismal in such cases.
Perforation of the bowel can happen either spontaneously due to tumor erosion of the wall, or it can be induced by chemotherapy.
Background
Metastatic lesions from head and neck tumours to the small bowel are extremely rare, and metastasis from tongue squamous cell carcinoma in particular has been reported only twice in the English literature.
Case presentation
A 76 year-old lady diagnosed with a loco-regionally advanced tongue squamous cell carcinoma but deferred surgical resection. Seven months later after her diagnosis, she presented with generalized abdominal pain, due to image-proven viscous perforation, thus taken for emergent exploratory laparotomy, where the perforation was found at the distal ileum, which was resected, and a primary side to side anastomosis was done. The histopathological examination of the resected segment revealed squamous cell carcinoma originating from the tongue. The patient was deteriorating clinically and vitally during her stay, and passed away on day 16 post operation due to multi-organ dysfunction syndrome.
Conclusion
Metastatic lesions from tongue carcinoma found in the vicinity of the small bowel represent a terminal stage with a dismal prognosis, and when these lesions present clinically with a complicated course, the survival rate is decreased significantly.
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