title: Jejunal perforation: an unusual presentation of metastatic cutaneous squamous cell carcinoma (SCC) in an immunosuppressed patient.
abstract: We report the rare occurrence of a small bowel perforation secondary to a metastatic cutaneous squamous cell carcinoma (cSCC). A 70-year-old woman, who had previously undergone renal transplantation, presented with severe, sudden-onset abdominal pain. She was peritonitic on initial examination, with evidence of free intra-abdominal air on radiographic imaging. During an exploratory laparotomy, she was found to have a perforated jejunum secondary to disseminated metastases seen throughout her peritoneum. Following histopathological analysis, as well as further imaging studies, the primary malignancy was eventually identified as a cSCC on her upper back. Palliative care was started and the patient died 8 weeks following her initial presentation.
authors.affiliation: John Radcliffe Hospital, Oxford, Oxfordshire, UK.
authors.forename: N
authors.initials: N
authors.lastname: Hitchen
authors.affiliation: Milton Keynes Hospital NHS Foundation Trust, Milton Keynes, UK.
authors.forename: D
authors.initials: D
authors.lastname: Warnapala
authors.affiliation: Department of Dermatology, Royal Berkshire NHS Foundation Trust, Reading, UK.
authors.forename: R M
authors.initials: RM
authors.lastname: Fisher
authors.forename: J
authors.initials: J
authors.lastname: Dua
authors.forename: P
authors.initials: P
authors.lastname: Pratsou
authors.affiliation: Royal Berkshire NHS Foundation Trust, Reading, UK.
authors.forename: A
authors.initials: A
authors.lastname: Freebairn
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000556:secondary*; D003937:Diagnosis, Differential; D055088:Early Detection of Cancer; D016099:Endoscopy, Gastrointestinal; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy; D007416:Intestinal Perforation / Q000209:etiology*; D007579:Jejunal Diseases / Q000209:etiology*; D016030:Kidney Transplantation; D010534:Peritoneal Neoplasms / Q000175:diagnosis / Q000556:secondary*; D049268:Positron-Emission Tomography; D011183:Postoperative Complications; D012878:Skin Neoplasms / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed