TITLE:
Squamous Cell Carcinoma of the Oropharynx Presenting with Distant Metastasis to the Ulna
AUTHORS:
Preetham Achoor Puthukudy, Musarrat Feshan
KEYWORDS:
Squamous Cell Carcinoma; Oropharyngeal Squamous Cell Carcinoma (OPSCC); Oropharynx; Distant Metastasis; Ulna; Head and Neck Cancer; Pathological Fracture
JOURNAL NAME:
International Journal of Otolaryngology and Head & Neck Surgery,
Vol.2 No.6,
November
8,
2013
ABSTRACT: Squamous cell carcinomas are the commonest malignancies
of the head and neck. Metastases from stage III and stage IV tumors occur most
commonly in the cervical lymph nodes. The incidence of distant metastases
occurring from such advanced tumors is anywhere between 10% and 40%.
Distant metastases occur most commonly to the lungs followed by the bone
and liver. The bone metastasis occurs commonly in the axial skeleton. We report
a rather unusual case of squamous cell carcinomas from the Head and
Neck region in a 77-year-old male metastasizing to the ulna. This case is even more
interesting because the presenting symptom was a pathological fracture of the ulna
for which he had reported to the orthopedic department. The
immunohistochemistry of the metastatic tumor had shown an unmistakable
squamous cell carcinoma with positive cytokeratin elements within the tumor. He
referred to the ENT department where he was diagnosed with T2N0M1 squamous cell
carcinoma of the oropharynx. The patient was treated with internal fixation and
bone cementing for the metastatic lesion, and primarily treated with chemoradiation.