Solitary cutaneous metastasis in the palmer aspect of the hand, along with pulmonary metastasis: A rare presentation in an early laryngeal primary and review of literature

Abstract

Cutaneous metastasis from head-and-neck cancer is extremely rare, reported in 1%–2% of patients. We report the case of a 67-year-old male with squamous cell carcinoma of epiglottis, who was treated with concurrent chemoradiotherapy. However, the patient developed metastatic nodule on the right palm proven by fine-needle aspiration cytology along with lung metastasis after 8 months of treatment completion despite the complete resolution of carcinoma at the primary site. In view of metastatic disease with poor functional status and controlled primary, he was started on weekly injectable methotrexate, palliative radiotherapy (RT) to palmar nodule with other measures of palliative care. However, he succumbed to disease after 8 months of postpalliative RT. This case report highlights that a seemingly curable disease within the larynx could take an aggressive turn in the form of lung metastasis and solitary palm nodule.