Isolated skeletal muscle metastasis following successful treatment of laryngeal cancer: case report
- PDF / 605,683 Bytes
- 6 Pages / 595.276 x 793.701 pts Page_size
- 1 Downloads / 143 Views
CASE REPORT
Open Access
Isolated skeletal muscle metastasis following successful treatment of laryngeal cancer: case report John R Klune1, Brian Zuckerbraun1,2, Allan Tsung1*
Abstract Skeletal muscle metastases from tumors are a rare occurrence and can present difficult management decisions. We report here on a patient that had been previously treated for squamous cell laryngeal cancer with surgical resection and adjuvant systemic chemotherapy that presented with a metastasis to the rectus abdominis muscle without evidence of recurrent disease at the primary site. After a metastatic workup with PET/CT scan suggested this to be an isolated lesion, surgical excision with negative margins was performed based upon limited treatment options secondary to the location of the tumor and his favorable prognosis suggested by his pathological staging at the time of the initial resection. Here we discuss the incidence of distant metastases from laryngeal cancer and appropriate screening methods. Additionally, skeletal muscle metastases and treatment considerations are discussed. Introduction Skeletal muscle metastases from cancer occur rarely and there are no clear guidelines for appropriate work-up and management of these lesions. Specifically, soft muscle metastases to the abdominal region provide exceptionally difficult treatment decisions based on location. While these can occur following percutaneous or surgical procedures in patients with head and neck cancers, it is extremely rare that one should occur in a patient without a history of any such procedures. Soft tissue metastases to muscle and skin generally represent undiscovered disease elsewhere and an overall poor prognosis. The case presented here occurred in a patient that had been successfully treated and had no signs of other recurrence on clinical exam or imaging studies. Therefore, this case presented a rare and difficult treatment strategy. Report of Case A 52-year-old male with a history of laryngeal cancer was found on routine physical examination to have a 2 cm subcutaneous nodule in the left mid-abdomen approximately 2 cm superior and 4 cm lateral to the * Correspondence: [email protected] 1 Department of Surgery, University of Pittsburgh, Pittsburgh, PA, 15213, USA
umbilicus. The mass was non-mobile and slightly tender to palpation. There was no erythema, induration, or cutaneous changes. The lesion had been asymptomatic and the patient had not been aware of this finding. Computed tomography (CT) scan of the abdomen and pelvis with intravenous contrast was performed, with the only pertinent finding being the mass localized within left rectus abdominis muscle (Figure 1A). This radiographic appearance of this was interpreted as a fluid filled lesion, concerning for abscess, hematoma, or seroma. Otolaryngology and general surgery consultations were obtained. The patient’s history was significant for a squamous cell carcinoma of the larynx, treated operatively seven months prior to this presentation with a total laryngectomy and bilateral selective neck diss
Data Loading...
