title: A case of metastatic squamous cell carcinoma of the hypopharynx manifesting as acute abdomen.
abstract: BACKGROUND
  Squamous cell head and neck cancers are usually confined to local and regional sites but occasionally, patients may present with rare manifestations of distant metastases.
  
  
  METHODS
  A 23-year-old female was treated with concurrent chemo-radiotherapy for stage IVA post-cricoid squamous cell carcinoma. A month later, she presented with acute abdomen and was found to have extensive peritoneal nodules at laparotomy. Intestinal obstruction soon followed.
  
  
  METHODS
  She was managed conservatively for the intestinal obstruction and given weekly paclitaxel.
  
  
  RESULTS
  She continued to deteriorate and succumbed shortly after the diagnosis of carcinomatosis peritoneii.
  
  
  CONCLUSIONS
  This rare and aggressive presentation reminds us to be cognizant of relapsed head and neck cancers manifesting atypically, and the need for more aggressive search of distant disease in at least some subgroups of head and neck cancer.
authors.affiliation: Department of Medical Oncology, National Cancer Centre, Singapore.
authors.forename: Z W
authors.initials: ZW
authors.lastname: Wong
authors.forename: S S
authors.initials: SS
authors.lastname: Leong
authors.forename: T
authors.initials: T
authors.lastname: Tan
authors.forename: K
authors.initials: K
authors.lastname: Mancer
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology*; D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000556:secondary*; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology*; D007415:Intestinal Obstruction / Q000209:etiology; D010534:Peritoneal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000556:secondary*