{"title":"Acute intestinal obstruction due to duodenal metastasis of laryngeal squamous cell carcinoma: A CARE case report.","authors":"Y Lelonge, A Havasi, N Williet, B Le Roy","doi":"10.1016/j.anorl.2025.02.004","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To report a case of duodenal metastasis of laryngeal squamous cell carcinoma revealed by acute intestinal obstruction.</p><p><strong>Case report: </strong>A 55-year-old male was initially treated for cT4N1M0 laryngeal squamous cell carcinoma, with total laryngectomy, bilateral neck dissection, total thyroidectomy and pectoralis major flap. Subsequently, he received radiotherapy and chemotherapy. Then, he was periodically monitored, with clinical examination and cervicothoracic CT, according to guidelines. Three years later, he presented acute intestinal obstruction. Abdominal CT revealed a 35mm obstructive duodenal tumor involving the head of the pancreas. Gastroscopy enabled biopsies, which confirmed metastasis of the laryngeal carcinoma. After gastro-entero-anastomosis, a first line treatment with cisplatin, 5-fluorouracile and pembrozilumab was started. It was complicated by abdominal bleeding, which required inferior duodenopancreatic artery embolization and colic perforation requiring colectomy. Due to deterioration in general health, 2 injections of pembrozilumab alone were made. Then, because of progression, the patient received 1 second-line injection of docetaxel. He finally died of acute pancreatitis, 7 months after diagnosis.</p><p><strong>Conclusion: </strong>Duodenal metastasis of squamous cell carcinoma of the larynx is rare but possible. This case report highlights the importance of clinical and radiological monitoring, particularly in locally advanced tumor.</p>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":" ","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Annals of Otorhinolaryngology-Head and Neck Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.anorl.2025.02.004","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To report a case of duodenal metastasis of laryngeal squamous cell carcinoma revealed by acute intestinal obstruction.
Case report: A 55-year-old male was initially treated for cT4N1M0 laryngeal squamous cell carcinoma, with total laryngectomy, bilateral neck dissection, total thyroidectomy and pectoralis major flap. Subsequently, he received radiotherapy and chemotherapy. Then, he was periodically monitored, with clinical examination and cervicothoracic CT, according to guidelines. Three years later, he presented acute intestinal obstruction. Abdominal CT revealed a 35mm obstructive duodenal tumor involving the head of the pancreas. Gastroscopy enabled biopsies, which confirmed metastasis of the laryngeal carcinoma. After gastro-entero-anastomosis, a first line treatment with cisplatin, 5-fluorouracile and pembrozilumab was started. It was complicated by abdominal bleeding, which required inferior duodenopancreatic artery embolization and colic perforation requiring colectomy. Due to deterioration in general health, 2 injections of pembrozilumab alone were made. Then, because of progression, the patient received 1 second-line injection of docetaxel. He finally died of acute pancreatitis, 7 months after diagnosis.
Conclusion: Duodenal metastasis of squamous cell carcinoma of the larynx is rare but possible. This case report highlights the importance of clinical and radiological monitoring, particularly in locally advanced tumor.
期刊介绍：
European Annals of Oto-rhino-laryngology, Head and Neck diseases heir of one of the oldest otorhinolaryngology journals in Europe is the official organ of the French Society of Otorhinolaryngology (SFORL) and the the International Francophone Society of Otorhinolaryngology (SIFORL). Today six annual issues provide original peer reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches and review articles giving most up-to-date insights in all areas of otology, laryngology rhinology, head and neck surgery. The European Annals also publish the SFORL guidelines and recommendations.The journal is a unique two-armed publication: the European Annals (ANORL) is an English language well referenced online journal (e-only) whereas the Annales Françaises d’ORL (AFORL), mail-order paper and online edition in French language are aimed at the French-speaking community. French language teams must submit their articles in French to the AFORL site.
Federating journal in its field, the European Annals has an Editorial board of experts with international reputation that allow to make an important contribution to communication on new research data and clinical practice by publishing high-quality articles.
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