title: [Rectal adenocarcinoma metastasis to the facial skin--case report].
abstract: BACKGROUND
  Carcinoma of the large intestine is a common and relatively well known neoplastic malignancy of the digestive tract. In a very few cases its spread seems unpredictable and can cause a distant metastasis to head and neck region.
  
  
  METHODS
  A 58 years old patient was admitted to the ENT Department because of an exulcerated tumour mass of the left mental and buccal region. 9 months earlier he underwent anterior resection of rectum due to carcinoma. Histopatological examination of specimen from the facial skin lesion revealed adenocarcinoma cells. Radiological findings suggested isolated character of lesion. The patient was treated by surgery and chemotherapy. Wide excision of tumour mass with partial mandibulectomy was performed and the tissue defect reconstructed with a pectoralis major musculocutaneous flap. A postoperative chemiotherapy with FA and 5-FU followed the surgical procedure. Regardless of the first promising results of the oncological treatment the patient died eight months later.
  
  
  CONCLUSIONS
  We present this case report as an example of an unusual and rare secondary malignancy of head and neck, emphasizing the interdisciplinary character of oncological treatment and the role of oncological vigilance on every step of diagnosis.
authors.affiliation: Oddział Otolaryngologii Chirurgii Głowy i Szyi Wojewódzkiego Szpitala Zespolonego w Toruniu. robwar@op.pl
authors.forename: Robert
authors.initials: R
authors.lastname: Warchoł
authors.forename: Leszek
authors.initials: L
authors.lastname: Szymański
authors.forename: Adam
authors.initials: A
authors.lastname: Seichter
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D005153:Facial Neoplasms / Q000556:secondary* / Q000628:therapy; D017809:Fatal Outcome; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D012878:Skin Neoplasms / Q000556:secondary* / Q000628:therapy
chemical_list: D002955:Leucovorin; D005472:Fluorouracil