HPV-Related Oropharyngeal Cancer Metastatic to Small Bowel Presenting as Small Bowel Obstruction – A Case Report and Systematic Review

Wanling Huang¹, Obiageli Offor¹, Anahat Kaur^2, , Lewis Steinberg² and Abhishek Kumar²

¹Department of Internal Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, Bronx, USA

²Department of Hematology-Oncology, Albert Einstein College of Medicine/Jacobi Medical Center, Bronx, USA

Cite this paper:
Wanling Huang, Obiageli Offor, Anahat Kaur, Lewis Steinberg and Abhishek Kumar. HPV-Related Oropharyngeal Cancer Metastatic to Small Bowel Presenting as Small Bowel Obstruction – A Case Report and Systematic Review. American Journal of Medical Case Reports. 2021; 9(8):420-423. doi: 10.12691/ajmcr-9-8-9

Abstract

Squamous cell carcinomas (SCC) account for the majority of all primary oropharyngeal carcinomas. These tumors can progress locally as well as metastasize to lymph nodes, the lung, bone, and liver. Metastases of primary laryngeal SCC to the small bowel is exceedingly rare and portends a poor prognosis as they often present with catastrophic symptoms. HPV-related head and neck SCC (HNSCC) is a peculiar subset of all HNSCC, and available data from prospective studies suggest better survival outcomes with HPV-related HNSCC compared to non-HPV-related HNSCC. In this article, we report the case of a patient who was managed at a tertiary hospital for a HPV-related laryngeal SCC with metastases to the small bowel presenting as small bowel obstruction (SBO). We also conducted a systematic review of HNSCC metastatic to small bowel with a focus on relation to HPV. We identified 13 reported cases of HNSCC metastatic to the small bowel. Of these, only 1 case was positive for p16 (a marker of HPV infection in HNSCC). We present the second case of HPV-related HNSCC with metastases to the small bowel.

Keywords:
HPV metastatic oropharyngeal head and neck cancer small bowel obstruction

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]	Jaiswal VR, Hoang MP. Primary combined squamous and small cell carcinoma of the larynx: a case report and review of the literature. Arch Pathol Lab Med 2004; 128(11): 1279-82.
[2]	Kotwall C, Sako K, Razack MS, et al. Metastatic patterns in squamous cell cancer of the head and neck. Am J Surg 1987; 154(4): 439-42.
[3]	Coca-Pelaz A, Rodrigo JP, Suarez C. Clinicopathologic analysis and predictive factors for distant metastases in patients with head and neck squamous cell carcinomas. Head & neck 2012; 34(6): 771-5.
[4]	De Castro CA, Dockerty MB, Mayo CW. Metastatic tumors of the small intestines. Surgery, gynecology & obstetrics 1957; 105(2): 159-65.
[5]	Airoldi M, Gabriele P, Succo G, et al. Small bowel metastasis from squamous cell carcinoma of the larynx. A case report. Tumori 1993; 79(4): 286-7.
[6]	Fakhry C, Zhang Q, Nguyen-Tan PF, et al. Human papillomavirus and overall survival after progression of oropharyngeal squamous cell carcinoma. J Clin Oncol 2014; 32(30): 3365-73.
[7]	Kerneis J.P. BoquienY GA, G. Dhelmeau. Épithélioma secondaire de l'intestin grêle. Á propos de cinq observations. Presse medicale (Paris, France: 1983) 1961; 69 879-82.
[8]	G. Lesur GP, M. Fabre, A. Vieillefond, C. Buffet. Métastaseiléale d’un cancer de l’amygdale. Gastroenterologie clinique et biologique 1988; 12: 292-93.
[9]	Bresler L, Corroy JS, Brunet A, et al. [Ileal metastasis of epidermoid carcinoma of the epiglottis. A case]. Presse medicale (Paris, France: 1983) 1988; 17(11): 536-7.
[10]	Hamdan M, Brunet P, Wagner J. [Metastatic jejunal perforation of cancer of the larynx]. Journal de chirurgie 1991; 128(6-7): 332.
[11]	Petiot JM, Lehur PA, Girard JY, et al. [Double perforation revealing duodenal and jejunal metastasis from epidermoid carcinoma of the larynx]. Gastroenterologie clinique et biologique 1991; 15(4): 370-1.
[12]	Claros Gonzalez I, Santonja Garriga JL, Rubio Barbon S, et al. [Jejunal perforation as initial metastatic manifestation of laryngeal carcinoma]. Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva 1994; 85(1): 41-4.
[13]	Wu CS, Chen CM, Tung SY, et al. Upper gastrointestinal bleeding due to metastatic gastric and duodenal squamous-cell carcinoma from the hypopharynx. Endoscopy 1996; 28(2): 262.
[14]	Yoshihara T, Yamamura Y. An unusual case of laryngeal carcinoma metastasizing to the small intestine. The Journal of laryngology and otology 1997; 111(6): 575-7.
[15]	Buyukcelik A, Ensari A, Sarioglu M, et al. Squamous cell carcinoma of the larynx metastasized to the ampulla of Vater. Report of a case. Tumori 2003; 89(2): 199-201.
[16]	Guillem P, Brygo A, Assila C, et al. [Small bowel metastases from head and neck cancers]. Annales de chirurgie 2004; 129(8): 422-6.
[17]	Arulraj P, Damodaran V, Raman ML, et al. Small bowel metastases from esophageal and oropharyngeal cancers. Indian journal of gastroenterology: official journal of the Indian Society of Gastroenterology 2005; 24(3):116-8.
[18]	Huang YC, Chang PM, Lee IC, et al. Duodenal squamous cell carcinoma derived from the hypopharynx: immunohistochemical assessment of metastatic mechanisms. Gastrointestinal endoscopy 2010; 72(2): 460-3.
[19]	Aoyagi Y, Matsuda K, Shimada R, et al. perforation of the small bowel due to metastasis from tongue cancer. Int Surg 2011; 96(1): 90-3.
[20]	Jacques J, Geyl S, Projetti F, et al. Obscure bleeding from gastrointestinal metastases of a head and neck squamous cell carcinoma. Endoscopy 2014;46 Suppl 1 UCTN: E18-9.
[21]	Glicksman JT, Bottoni D, Shepherd J, et al. carcinoma of the larynx, metastatic to ileum, presents as ruptured appendicitis: case report and literature review. Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale 2014; 43: 18.
[22]	Amit P Patel KGN, Marino Leon,Domenico Coppola. HPV Related Squamous Cell Carcinomas of the Head and Neck Metastatic to the Small Bowel: First Case Report and Review of the Literature. The Federation of American Societies For Experimental Biology Journal 2016; 30(1): lb1-1300.18.
[23]	Dwivedi RC, Kazi R, Agrawal N, et al. Comprehensive review of small bowel metastasis from head and neck squamous cell carcinoma. Oral Oncol 2010; 46(5): 330-5.
[24]	Sanchez D G-RL, Umar B, Chang S. Small Bowel Obstruction: A Result of Metastatic Head and Neck Squamous Cell Carcinoma. Ann Clin Otolaryngol 2017; 2(2): 1011.