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Case Reports
. 2024 Sep 20;16(9):e69826.
doi: 10.7759/cureus.69826. eCollection 2024 Sep.

Duodenal Squamous Cell Carcinoma From Metastatic Spread of Head and Neck Cancer: A Case Report

Milaris M Sanchez-Cordero  1 , Felix Rivera Troia  2   3 , Fernando J Ocasio Villa  4   5
Affiliations
Case Reports

Duodenal Squamous Cell Carcinoma From Metastatic Spread of Head and Neck Cancer: A Case Report

Milaris M Sanchez-Cordero et al. Cureus. .

Abstract

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.

Keywords: cancer metastasis; duodenal squamous cell carcinoma; head and neck cancer (h&n cancer); oncology; squamous cells carcinoma.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Axial view of abdominal CT scan showing diffuse small bowel distention measuring up to 5.3 cm in the pelvis, with an abrupt change in caliber in the right lower quadrant
The terminal ileum collapsed.
Figure 2
Figure 2. Axial view of head CT scan showing a hypodense laryngeal mass measuring 2.4 x 1.0 x 2.3 cm extending inferiorly into the left aryepiglottic fold and left vocal cord and extensive bilateral necrotic cervical lymphadenopathy measuring up to 5.7 x 3.6 cm
See this image and copyright information in PMC

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