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Abstract
Small intestinal metastasis from head and neck tumors is very rare. We herein report the case of a 71-yearold male with severe duodenal stricture due to duodenal metastasis from head and neck cancer whose duodenal stricture was conservatively relieved by endoscopic stenting. The patient had been treated with total laryngectomy and postoperative radiotherapy 13 months before visiting our department with complaints of a loss of appetite and vomiting. Esophagogastroscopy revealed a large submucosal tumor with severe obstruction in the duodenum. The histological findings of biopsy specimens showed moderately differentiated squamous cell carcinoma. He was thus diagnosed to have duodenal metastasis from the original supraglottic larynx cancer. Because his general condition was not sufficient to allow additional chemo-radiotherapy or surgery to be performed, conservative endoscopic stenting was employed to relieve the obstructive symptoms. After the stenting, the symptoms all immediately disappeared. When patients with head and neck tumors present with gastrointestinal bleeding and/or symptoms such as intestinal obstruction, endoscopic stenting appears to be useful for the palliative relief of such symptoms.
Highlights
Distant metastasis after the initial treatment of head and neck cancers is closely associated with a poor prognosis [1,2]
We described a successful case of conservative endoscopic stenting for a rare duodenal metastasis from head and neck cancer with severe stricture
Most of the metastatic sites from head and neck tumors are in the lungs, bone and liver [3,4,5,6,7,8,9], and only five cases of small intestinal metastasis from such tumors have been reported in the English literature, including the present case (Table 1) [10,11,12,13]
Summary
Distant metastasis after the initial treatment of head and neck cancers is closely associated with a poor prognosis [1,2]. While the most common sites of the distant metastasis of head and neck squamous cell carcinoma are the lungs, followed by the bone and the liver [3,4,5,6,7], only a few cases of metastases in the small bowel have been reported [811]. We report a case of duodenal metastasis from supraglottic laryngeal cancer with a severe intestinal stricture that was successfully treated by endoscopic stenting.
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