Posters
Academic Level (Author 1)
Medical Student
Academic Level (Author 2)
Medical Student
Academic Level (Author 3)
Faculty
Discipline/Specialty (Author 3)
Otolaryngology-Head and Neck Surgery
Academic Level (Author 4)
Faculty
Discipline/Specialty (Author 4)
Otolaryngology-Head and Neck Surgery
Discipline Track
Community/Public Health
Abstract
Introduction/Background: Colorectal Adenocarcinoma (CRC) metastasis is found in approximately 1 in 5 patients diagnosed with CRC and frequently spreads to the liver, lungs, peritoneum, bone, and nervous system. There are several subtypes of adenocarcinoma but the single most associated with distant metastasis, multiple sites of metastasis, and poorer survival is the signet-ring cell carcinoma variant. We present an unusual case of a head and neck mass demonstrating immunohistochemical staining specific for colorectal origin in a patient with a history of mucinous adenocarcinoma of the colon.
Case Presentation: A 53-year-old female was referred for a left cervical neck mass associated with newly developed left eye ptosis and dryness. Physical examination confirmed the presence of a palpable, non-fluctuant, left level IV neck mass with no cervical lymphadenopathy. Further evaluation of social and medical history concluded that patient was a non-smoker and never consumed alcohol but did have previous mucinous adenocarcinoma that was treated with a hemicolectomy and was currently in remission. Immunohistochemical stains of ultrasound fine needle aspiration biopsy revealed malignant cells to be partially reactive to CK20 and CDX2, while negative for CK7 – a relatively specific staining pattern for intestinal origin.
Discussion: Colorectal cancer presenting with metastasis at diagnosis. are associated with poorer prognoses and a 5-year relative survival rate of 15.1%. Head and neck metastasis is rare and challenging to explain due to the lack of an apparent lymphatic route. Metastasis to the head and neck region from primary infraclavicular tumors may occur via the thoracic duct, potentially leading to left-sided supraclavicular pathology, as observed in this case. Management of such cases requires a multidisciplinary approach, including surgical resection, chemotherapy, and potentially adjuvant radiotherapy.
Conclusions: In conclusion, this case report highlights the importance of considering primary infraclavicular cancers as part of a complete differential diagnosis when evaluating head and neck metastasis. Acknowledging this potential may provide enhanced insight in delivering patient-centered, evidence-based treatment options and disease management that can ultimately improving patient outcome.
Presentation Type
Poster
Recommended Citation
Al Hassan, Taha; Flores, Jessica; Bender-Heine, Adam; and Giese, Rachel A., "Head and Neck Metastasis of Colorectal Adenocarcinoma: A Case Report and Literature Review" (2024). Research Colloquium. 19.
https://scholarworks.utrgv.edu/colloquium/2024/posters/19
Included in
Anatomy Commons, Gastroenterology Commons, Otolaryngology Commons, Pathology Commons, Surgery Commons
Head and Neck Metastasis of Colorectal Adenocarcinoma: A Case Report and Literature Review
Introduction/Background: Colorectal Adenocarcinoma (CRC) metastasis is found in approximately 1 in 5 patients diagnosed with CRC and frequently spreads to the liver, lungs, peritoneum, bone, and nervous system. There are several subtypes of adenocarcinoma but the single most associated with distant metastasis, multiple sites of metastasis, and poorer survival is the signet-ring cell carcinoma variant. We present an unusual case of a head and neck mass demonstrating immunohistochemical staining specific for colorectal origin in a patient with a history of mucinous adenocarcinoma of the colon.
Case Presentation: A 53-year-old female was referred for a left cervical neck mass associated with newly developed left eye ptosis and dryness. Physical examination confirmed the presence of a palpable, non-fluctuant, left level IV neck mass with no cervical lymphadenopathy. Further evaluation of social and medical history concluded that patient was a non-smoker and never consumed alcohol but did have previous mucinous adenocarcinoma that was treated with a hemicolectomy and was currently in remission. Immunohistochemical stains of ultrasound fine needle aspiration biopsy revealed malignant cells to be partially reactive to CK20 and CDX2, while negative for CK7 – a relatively specific staining pattern for intestinal origin.
Discussion: Colorectal cancer presenting with metastasis at diagnosis. are associated with poorer prognoses and a 5-year relative survival rate of 15.1%. Head and neck metastasis is rare and challenging to explain due to the lack of an apparent lymphatic route. Metastasis to the head and neck region from primary infraclavicular tumors may occur via the thoracic duct, potentially leading to left-sided supraclavicular pathology, as observed in this case. Management of such cases requires a multidisciplinary approach, including surgical resection, chemotherapy, and potentially adjuvant radiotherapy.
Conclusions: In conclusion, this case report highlights the importance of considering primary infraclavicular cancers as part of a complete differential diagnosis when evaluating head and neck metastasis. Acknowledging this potential may provide enhanced insight in delivering patient-centered, evidence-based treatment options and disease management that can ultimately improving patient outcome.