title: Skin metastasis of hypopharyngeal carcinoma to the nasal tip.
abstract: Head and neck squamous cell carcinoma (SCC) rarely metastasizes to the skin. Metastases to the nasal tip from hypopharyngeal malignancies are extremely rare. We present a patient with nasal tip metastasis from hypopharyngeal SCC. A 74-year-old man with hypopharyngeal and esophageal carcinomas had a red nodule on his nasal tip (so-called "clown nose"). Histopathologically, atypical squamoid cell nests had proliferated in a lobular fashion from the dermis to subcutaneous tissue. Those atypical cells were identical to primary tumor cells in the hypopharynx. Based on these findings, a diagnosis of skin metastasis from hypopharyngeal SCC was made. In patients with malignant disease, biopsy should be performed for any suspicious skin lesion. In a patient like ours, "clown nose" might be a symptom of cutaneous metastasis. When clinicians note a "clown nose", they should consider malignancies in the neck and chest areas.
authors.affiliation: Clinic of Dermatology, National Hospital Organization Hamada Medical Center, Hamada 697-8511, Japan ; †Division of Dermatology, Department of Medicine of Sensory and Motor Organs, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.
authors.forename: Masahisa
authors.initials: M
authors.lastname: Shindo
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Yoshida
authors.forename: Kyoko
authors.initials: K
authors.lastname: Tominaga
authors.forename: Osamu
authors.initials: O
authors.lastname: Yamamoto
keywords: hypopharyngeal; metastasis; nasal tip
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