Hypopharyngeal squamous cell carcinoma (HSCC) is a highly aggressive malignancy constituting a small proportion of all head and neck cancers. While it has significant metastatic potential, spread to the stomach is exceedingly rare. A case of HSCC with metastasis to the stomach is presented, along with a review of the relevant literature. A 71-year-old male patient with a history of HSCC was admitted to the hospital for melena and anemia. Prior to this presentation, he had documented metastases to the lungs and small bowel. Esophagogastroduodenoscopy (EGD) demonstrated a friable, non-bleeding gastric ulcer with raised margins. Biopsy findings were consistent with metastatic HSCC. He was considered for enrollment in potential oncological clinical trials. We find that while metastasis to the stomach can occur in certain cancers such as breast, lung, and renal cell carcinoma, it is not common in hypopharyngeal cancer. A review of the literature reports only three previous cases. Multiple potential therapeutic molecular biomarkers have been identified for metastatic HSCC. The endoscopist should always consider metastatic disease when evaluating malignant stomach ulcers.
Kabbara et al. (Tue,) studied this question.