2023 Volume 116 Issue 9 Pages 893-898
Metastatic carcinomas in the head and neck region are relatively rare, with hypopharyngeal metastasis being exceptionally rare. Herein, we report a case of hypopharyngeal metastasis from a uterine leiomyosarcoma.
A 61-year-old woman undergoing systemic chemotherapy for a uterine leiomyosarcoma was referred to our department from the Department of Oncology for sore throat and dysphagia. Fiberoptic laryngoscopy revealed a smooth and raised lesion in the right piriform sinus of the hypopharynx. As an inflammatory cause was suspected, biopsy was not performed. After some months, the lesion became ulcerated, prompting the need for a biopsy. The biopsy results indicated metastatic leiomyosarcoma, and the patient was diagnosed as having a hypopharyngeal metastasis from uterine leiomyosarcoma. The patient was initiated on systemic chemotherapy, however, her condition continued to deteriorate and she eventually died of disease progression.
Primary kidney and lung cancers may metastasize to the nasal sinuses and pharynx, with the tonsils being the most frequently affected pharyngeal structure. However, hypopharyngeal metastasis is exceptionally rare.
A hematogenous route of spread was considered for the hypopharyngeal metastasis in this case. However, whether the hematogenous metastasis occurred through the pulmonary circulation or vertebral venous plexus remains debatable.
Initial manifestations of metastases to the head and neck include minor symptoms such as pharyngeal discomfort. Thus, it is necessary to pay attention to even minor symptoms in patients with cancer.
The life expectancy in patients with metastasis to the head and neck region is usually less than 1 year. Therefore, it is necessary to thoroughly consider treatments according to the patient’s condition.
