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Cutaneous metastasis from squamous carcinoma of the base of tongue.

Rahman T, Krishnatreya M, Sarma A, Kumar M, Kataki AC - N Am J Med Sci (2015)

Bottom Line: But, there was complete resolution of the tumor at the primary site.The metastasis to the skin of face clinically appeared like an inflammatory lesion.Fine needle aspiration cytology confirmed the diagnosis of metastasis to skin at both the sites.

View Article: PubMed Central - PubMed

Affiliation: Department of Head and Neck Oncology, Dr. B Borooah Cancer Institute, Guwahati, Assam, India.

ABSTRACT

Context: Cutaneous metastasis from head and neck cancer is uncommon and it is seen from laryngeal cancer. Cutaneous metastasis from the base of tongue is relatively rare.

Case report: A 55-year-old male, who was a treated case of squamous carcinoma of the base of tongue presented with metastatic nodule on the skin of face and thigh. But, there was complete resolution of the tumor at the primary site. In the present case, clinically obvious cutaneous nodules with metastasis appeared soon after the completion of treatment with concurrent chemo-radiotherapy. The metastasis to the skin of face clinically appeared like an inflammatory lesion. Fine needle aspiration cytology confirmed the diagnosis of metastasis to skin at both the sites.

Conclusion: Our case has highlighted that there could be associated occult skin metastasis at the time of diagnosis in squamous carcinoma of the base of tongue.

No MeSH data available.


Related in: MedlinePlus

CT scan image showing a heterogeneously enhanced soft tissue mass of 48 mm × 35 mm in the left infra-zygomatic region
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Figure 2: CT scan image showing a heterogeneously enhanced soft tissue mass of 48 mm × 35 mm in the left infra-zygomatic region

Mentions: A 55-year-old male, chronic tobacco chewer presented to our institute with history of occasional throat pain and hoarseness of 4 months duration, which was subsequently diagnosed as squamous carcinoma of the BOT with bilateral secondary neck node (T3N2cM0, stage IV). The patient was treated by concurrent external beam radiotherapy (EBRT) of 70 Gy/35# and weekly chemotherapy with carboplatin (150 mg). The patient tolerated EBRT and chemotherapy well. At the 3 months follow-up from the completion of treatment, the patient presented with a progressive growing nodule on the left side of the face and thigh of 2 month's duration [Figure 1]. On local examination, there was 4 cm × 4 cm firm, mobile, slightly tender and inflamed sub-cutaneous nodule on the skin of left zygomatic region. The skin nodule on the left thigh was ulcerated, hard, fixed and tender. The thigh swelling was of 5 cm × 5 cm in its maximum dimension. Computed tomogram (CT) scan of the head and neck showed nodular mass in the pre-maxillary infra-zygomatic region [Figure 2]. Endoscopic examination showed post EBRT changes at the BOT without any evidence of an ulcer or growth. Fine needle aspiration cytology (FNAC) from the infra-zygomatic nodule and thigh lesion revealed metastatic squamous carcinoma [Figure 3]. The final staging this time was T0N0M1 (Stage IV). The patient was planned and treated by palliative chemotherapy with methotrexate 50 mg and 5-FU 500 mg three times weekly. There was no response after four cycles. So, the patient was not willing to receive chemotherapy anymore. At 4 months from the date of diagnosis of metastasis the patient was alive.


Cutaneous metastasis from squamous carcinoma of the base of tongue.

Rahman T, Krishnatreya M, Sarma A, Kumar M, Kataki AC - N Am J Med Sci (2015)

CT scan image showing a heterogeneously enhanced soft tissue mass of 48 mm × 35 mm in the left infra-zygomatic region
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4325393&req=5

Figure 2: CT scan image showing a heterogeneously enhanced soft tissue mass of 48 mm × 35 mm in the left infra-zygomatic region
Mentions: A 55-year-old male, chronic tobacco chewer presented to our institute with history of occasional throat pain and hoarseness of 4 months duration, which was subsequently diagnosed as squamous carcinoma of the BOT with bilateral secondary neck node (T3N2cM0, stage IV). The patient was treated by concurrent external beam radiotherapy (EBRT) of 70 Gy/35# and weekly chemotherapy with carboplatin (150 mg). The patient tolerated EBRT and chemotherapy well. At the 3 months follow-up from the completion of treatment, the patient presented with a progressive growing nodule on the left side of the face and thigh of 2 month's duration [Figure 1]. On local examination, there was 4 cm × 4 cm firm, mobile, slightly tender and inflamed sub-cutaneous nodule on the skin of left zygomatic region. The skin nodule on the left thigh was ulcerated, hard, fixed and tender. The thigh swelling was of 5 cm × 5 cm in its maximum dimension. Computed tomogram (CT) scan of the head and neck showed nodular mass in the pre-maxillary infra-zygomatic region [Figure 2]. Endoscopic examination showed post EBRT changes at the BOT without any evidence of an ulcer or growth. Fine needle aspiration cytology (FNAC) from the infra-zygomatic nodule and thigh lesion revealed metastatic squamous carcinoma [Figure 3]. The final staging this time was T0N0M1 (Stage IV). The patient was planned and treated by palliative chemotherapy with methotrexate 50 mg and 5-FU 500 mg three times weekly. There was no response after four cycles. So, the patient was not willing to receive chemotherapy anymore. At 4 months from the date of diagnosis of metastasis the patient was alive.

Bottom Line: But, there was complete resolution of the tumor at the primary site.The metastasis to the skin of face clinically appeared like an inflammatory lesion.Fine needle aspiration cytology confirmed the diagnosis of metastasis to skin at both the sites.

View Article: PubMed Central - PubMed

Affiliation: Department of Head and Neck Oncology, Dr. B Borooah Cancer Institute, Guwahati, Assam, India.

ABSTRACT

Context: Cutaneous metastasis from head and neck cancer is uncommon and it is seen from laryngeal cancer. Cutaneous metastasis from the base of tongue is relatively rare.

Case report: A 55-year-old male, who was a treated case of squamous carcinoma of the base of tongue presented with metastatic nodule on the skin of face and thigh. But, there was complete resolution of the tumor at the primary site. In the present case, clinically obvious cutaneous nodules with metastasis appeared soon after the completion of treatment with concurrent chemo-radiotherapy. The metastasis to the skin of face clinically appeared like an inflammatory lesion. Fine needle aspiration cytology confirmed the diagnosis of metastasis to skin at both the sites.

Conclusion: Our case has highlighted that there could be associated occult skin metastasis at the time of diagnosis in squamous carcinoma of the base of tongue.

No MeSH data available.


Related in: MedlinePlus