Metastatic Squamous Cell Carcinoma of the Duodenum: A Case Report and Literature Review
Format
Presentation
Start Date
6-11-2020 1:00 PM
End Date
6-11-2020 1:15 PM
Abstract
Introduction: Squamous cell carcinoma (SCC) of the bladder accounts for only about 3-5% of all bladder cancers and metastatic disease to the small intestine is even more infrequent. Case description: We present the case of a 40-year-old male with a history of congenital spina bifida, who developed bladder SCC four years ago. During that time, he underwent radical cystectomy with rectal resection and continent ileal conduit, as well as end colostomy. Subsequently, he underwent external beam radiation therapy. He now presents with abdominal pain, distention, and vomiting consistent with upper GI obstruction. CT scan revealed a large obstructing mass in the duodenum without retroperitoneal adenopathy or evidence of pelvic recurrence. The mass was biopsied, which revealed squamous cell carcinoma. Multidisciplinary discussion recommended curative resection as further imaging revealed no other metastatic lesions. This mass was resected en-bloc with the right colon, 3rd and 4th portions of the duodenum, and part of the pancreas. The patient recuperated well and was sent home with a drain to monitor any anastomotic leaks. Final pathology report showed a 9.0 cm SCC of the duodenum infiltrating adjacent organs, with 2 positive lymph nodes and negative margins. Discussion: SCC involvement of any organ has similar histo-pathological characteristics. However, given the prior history of bladder SCC treated 4 years ago and positive lymph nodes, it is highly likely this is a metastasis to the duodenum and adjacent organs.
Metastatic Squamous Cell Carcinoma of the Duodenum: A Case Report and Literature Review
Introduction: Squamous cell carcinoma (SCC) of the bladder accounts for only about 3-5% of all bladder cancers and metastatic disease to the small intestine is even more infrequent. Case description: We present the case of a 40-year-old male with a history of congenital spina bifida, who developed bladder SCC four years ago. During that time, he underwent radical cystectomy with rectal resection and continent ileal conduit, as well as end colostomy. Subsequently, he underwent external beam radiation therapy. He now presents with abdominal pain, distention, and vomiting consistent with upper GI obstruction. CT scan revealed a large obstructing mass in the duodenum without retroperitoneal adenopathy or evidence of pelvic recurrence. The mass was biopsied, which revealed squamous cell carcinoma. Multidisciplinary discussion recommended curative resection as further imaging revealed no other metastatic lesions. This mass was resected en-bloc with the right colon, 3rd and 4th portions of the duodenum, and part of the pancreas. The patient recuperated well and was sent home with a drain to monitor any anastomotic leaks. Final pathology report showed a 9.0 cm SCC of the duodenum infiltrating adjacent organs, with 2 positive lymph nodes and negative margins. Discussion: SCC involvement of any organ has similar histo-pathological characteristics. However, given the prior history of bladder SCC treated 4 years ago and positive lymph nodes, it is highly likely this is a metastasis to the duodenum and adjacent organs.