■小肠的原发性和转移性癌很少见。虽然这些恶性肿瘤大多是腺癌,胃肠道鳞状细胞癌(SCC)并不常见。我们提供了一例罕见的皮肤SCC转移到回肠的病例报告,强调诊断挑战和临床意义。
方法:一名83岁的女性在急诊就诊前两年有右侧颞区皮肤SCC切除史,随后在接受放射治疗的右侧腮腺内淋巴结转移复发。患者出现感染性休克和急腹症,腹部计算机断层扫描显示肠穿孔的迹象。急诊剖腹探查术证实化脓性腹膜炎和末端回肠穿孔。随后,进行了20厘米的肠切除术。切除标本的组织病理学检查显示小肠有4厘米穿孔的SCC(pT4pN0L0V1Pn0R0)。
■小肠的转移很少见。这些转移的主要部位通常是子宫,子宫颈,结肠,肺,乳房,或者黑色素瘤.小肠的SCC特别罕见,并且由于非特异性症状而在诊断中提出了挑战。小肠SCC的预后通常较差,某些皮肤SCC的潜在攻击行为强调了在处理此类病例时需要提高意识和警惕。
结论:本病例报告强调,对于有皮肤SCC病史并出现新发腹部症状的患者,考虑小肠转移性疾病的重要性。
UNASSIGNED: Primary and metastatic carcinoma of the small intestine are rare. While most of these malignancies are adenocarcinomas, squamous cell carcinoma (SCC) of the gastrointestinal tract is uncommon. We present a
case report of a rare occurrence of skin SCC metastasizing to the ileum, highlighting diagnostic challenges and clinical implications.
METHODS: An 83-year-old female had a history of cutaneous SCC excision in the right temporal region two years prior to the current emergency department visit, followed by metastatic recurrence in a right intra-parotid lymph node treated with radiotherapy. The patient exhibited septic shock and an acute abdomen, and an abdominal computed tomography scan revealed signs of intestinal perforation. Emergency exploratory laparotomy confirmed purulent peritonitis and perforation of the terminal ileum. Subsequently, a 20 cm intestinal resection was performed. Histopathological examination of the resected specimen revealed a 4 cm perforated SCC of the small intestine (pT4 pN0 L0 V1 Pn0 R0).
UNASSIGNED: Metastases of the small intestine are rare. The primary sites for these metastases are typically the uterus, cervix, colon, lung, breast, or melanoma. SCC of the small intestine is particularly rare and poses challenges in diagnosis owing to non-specific symptoms. The prognosis for SCC of the small intestine is generally poor, and the potentially aggressive behavior of some skin SCC emphasizes the need for increased awareness and vigilance in managing such cases.
CONCLUSIONS: This
case report underscores the importance of considering metastatic disease in the small bowel of patients with a history of skin SCC who present with new-onset abdominal symptoms.