title: Metastatic squamous cell carcinoma from hand skin causing small bowel obstruction: an unusual case presentation.
abstract: The small bowel rarely suffers from metastatic tumors from outside the abdomen. Small bowel obstructions caused by the metastatic spread of squamous cell carcinoma (SCC) of the hand to the intestines are even rarer. A 71-year-old man with intermittent abdominal distension and pain for 4 months was diagnosed with partial bowel obstruction. The patient underwent a video capsule endoscopic examination; however, the patient was unable to pass the capsule, which worsened the abdominal distension. He was transferred to our department for acute intestinal obstruction, and an emergency exploratory laparotomy was performed. Intraoperatively, a tumoral stricture of the intestine at a distance of 150 cm from the ileo-cecum and dilation of the proximal bowel was found. The involved segment was resected, and ileo-ileal anastomosis was performed. The pathological sections confirmed the lesion to be a moderately differentiated SCC with whole bowel layer infiltration. Immunohistochemical staining showed positive expression of cytokeratin 5/6 and p63. The patient had an uneventful recovery. However, 6 months later, he was hospitalized again with intestinal obstruction. Reoperation was performed and revealed multiple metastases in the small bowel. He died 4 months later. In this unusual case, metastasizing SCC of the hand skin led to intestinal obstruction and poor prognosis. Therefore, follow-up procedures regarding intestinal spread should be performed in patients with SCC who present with abdominal symptoms.
authors.forename: Ruixin
authors.initials: R
authors.lastname: Li
authors.forename: Zihua
authors.initials: Z
authors.lastname: Chen
authors.forename: Qiaocheng
authors.initials: Q
authors.lastname: Wen
authors.affiliation: Department of Gastrointestinal Surgery, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, China. chenzk1974@hotmail.com.
authors.forename: Zhikang
authors.initials: Z
authors.lastname: Chen
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000150:complications* / Q000556:secondary; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000473:pathology; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D011379:Prognosis; D012878:Skin Neoplasms / Q000150:complications* / Q000473:pathology