Abstract
Importance. Laryngeal cancer infrequently results in distant metastases, but metastasis to skeletal muscle is extremely uncommon. Observations. A 55-year-old male presenting with progressive dyspnea and hoarseness was found to have Stage IVA T4aN2cM0 laryngeal cancer and eventually underwent total laryngectomy. Before the patient could be started on adjuvant chemoradiation, the patient developed masses on both thighs. Biopsy revealed metastatic squamous cell carcinoma consistent with the primary laryngeal cancer. He was offered palliative chemotherapy; however, he developed new soft tissue masses to the left of his stoma and in the prevertebral area one week later. He also had new cervical and supraclavicular nodes and a pathological compression fracture of L3. Patient died within 4 months of diagnosis. Conclusions. Distant metastasis such as skeletal metastasis portends a poor prognosis. Further studies are required to determine the best course of treatment in these patients.
Highlights
It is estimated that 12,630 men and women will be diagnosed with laryngeal cancer in 2014
We present the case of a patient with locally advanced laryngeal squamous cell carcinoma who developed skeletal muscle metastases to both thighs shortly after definitive surgical treatment of the primary cancer
To the best of our knowledge, this is only the third case of laryngeal cancer with metastases to skeletal muscles of the lower extremities reported in the English literature [2, 3]
Summary
It is estimated that 12,630 men and women will be diagnosed with laryngeal cancer in 2014. The most common site of distant metastases from laryngeal cancer is the lung. Distant metastasis to the skeletal muscle is extremely unusual. There are only two reported cases of metastatic laryngeal carcinoma to the musculature of the lower extremities in the literature [2]. We present the case of a patient with locally advanced laryngeal squamous cell carcinoma who developed skeletal muscle metastases to both thighs shortly after definitive surgical treatment of the primary cancer. This case raises awareness of skeletal muscle metastasis and its implications in the management of high-risk laryngeal cancer patients
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