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Clinical Case Reports 2018: Small bowel obstruction from metastatic mesenteric/omental infiltration from a cutaneous squamous cell carcinoma: A rare presentation- Veral Vishnoi- University of Newcastle

Abstract

  We present a 57-year-old male with known metastatic cutaneous Squamous Cell Carcinoma (SCC) with an unknown primary presenting with a small bowel obstruction. Malignancies of the small bowel are rarely primary, but rather dominated by metastatic melanoma followed by metastatic adenocarcinoma from the pancreas, colon or stomach. Metastatic cutaneous SCC travels to lymph nodes, brain, bone, lung, skin and very rarely to the gastrointestinal tract. Our patient had been on palliative chemotherapy when he presented with a one week history of nausea, progressing to feculent vomiting, abdominal distension and obstipation. A computed tomography scan demonstrated significant stranding around the omentum and mesenteric fat with a small cystic mesenteric mass with a resultant small bowel obstruction. Given that patients advanced disease a conservative approach was taken with gastric decompression via a nasogastric tube and intravenous fluid resuscitation. A radiological guided fine needle aspiration of the mass was performed, confirming cutaneous SCC, which is a very rare occurrence. Stomach is an unordinary site for metastasis. Data on duodenal metastasis is commonly restricted to single case reports. Gastric injuries are distinguished in under 2% of patients with disease of cervix and are generally asymptomatic.Melanoma, lung, bosom and throat are the regular essential metastatic locales. Indications of metastatic tumors incorporate torment, heaving and draining yet are vague. Cervical malignancy is known for its nearby penetration and the sequelae of neighborhood inclusion establish the basic reasons for mortality, for example, ureteral injury, uremia auxiliary to block, urosepsis and neighborhood dying. Inaccessible metastasis from disease cervix is exceptionally uncommon and restricted to secluded case reports with malignant growth cachexia and metastasis establishing an unprecedented reason for death. This case endeavors to feature an uncommon reason for mortality from cervical malignant growth with gastric draining optional to an unordinary movement of ailment.  

 Veral Vishnoi

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