Skin Metastases in Squamous Cell Carcinoma of the Head and Neck: A Retrospective Study and Review of Literatures
王維吟(Wei-Yin Wang)；洪士涵(Shi-Han Hong)；張燕良(Yen-Liang Chang)
頭頸部鱗狀上皮細胞癌 ； 皮膚轉移 ； 遠端轉移 ； squamous cell carcinoma of the head and neck ； skin metastases ； distant metastases
|Volume or Term/Year and Month of Publication||
46卷1期（2011 / 02 / 01）
1 - 5
BACKGROUND: The objective of this article trys to answer the following questions: 1. What is the incidence of skin metastases (SMs) in squamous cell carcinoma of the head and neck (SCCHN) patients? 2. Is there any difference in the incidence of SMs among patients with various primary sites, clinical stages, and histologic grade? 3. What sites of skin are head and neck cancers prone to metastasize to? 4. Are SMs related to the treatment regimen? 5. What is the timing of SMs development? 6. What is the survival of patient with SMs?.METHODS: A retrospective chart review of patients with SCCHN between July, 2003 and December, 2008 was conducted. Patients with SMs were identified. Several data and factors were analysed.RESULTS: There were 425 patients with SCCHN, including oral cavity (141 cases), nasopharynx (113 cases), oropharynx (70 cases), hypopharynx (51 cases), larynx (42 cases), nose (6 cases), external auditory canal (1 case), and parotid gland (1 case). 10 patients with SMs were identified, including oral cavity (6 cases), oropharynx (2 cases), hypopharynx (1 case), supraglottis (1 case). The clinical stages were as follows: stage one (2 cases), stage two (2 cases), stage three (1 case), and stage four (5 cases). Histopathologic grading were as follows: well differentiated (2 cases), moderately differentiated (6 cases), and poorly differentiated (2 case). All patients were diagnosed to have SMs at or after the locoregional recurrence. And all patients with SMs had received prior neck dissection and radiotherapy. The time for onset of SMs ranged from 6 months to 45 months. The survival time after the development of SMs ranged from a month to 11 months.CONCLUSION: SMs are uncommon in SCCHN. Patients with SMs have poor survival rate. The development of SMs is not related with clinical stages and tumor histopathologic grading. All the patients with SMs received neck surgery and radiotherapy. The local spread which is through dermal lymphatics is considered as the main mechanism.