Key Clinical MessageThis is an interesting case that highlights the variability of the clinical course of sarcoidosis and the importance of the knowledge of the clinical and radiologic features of the disease for its diagnosis and management.
Background: Squamous cell carcinoma of the pyriform sinus(SCCPS) is a rare tumour with poor prognosis due to delayed diagnosis. It usually metastasizes to the lymphatic region or nearby organs. Distant dissemination is uncommon. We report the case of a patient diagnosed with SCCPS and a single liver metastasis. Methods: A 63-year-old man diagnosed with SCCPS 3 years ago, stage IVa(T1N2b), treated with QT/RT and a complete response. A control CT showed a liver mass of 68x59x48mm located in segments V-VI. The biopsy demonstrated a liver metastasis of SCCPS. The patient received 6 cycles of QT, with partial response. We decided to perform a segmentectomy V-VI. The specimen was compatible with metastasis of SCCPS, poorly differentiated. At present free-disease after 8 months. Results: SCCPS is the most frequently tumour in hypopharynx(70%), with an incidence of 1750/year. It is usually found in patients with tobacco or ethanol abuse. Only a small percentage present with early stage(T1-T2)without nodal involvement or distant metastases. Those are rare, with an incidence of 5%. Most of these patients have stage III or IV disease at presentation and, when present, they commonly involve lung and mediastinum(53%), bone(15%), skin(7%), and CNS(3%). To the present, this is the first report describing a liver metastasis from SCCPS resected. Conclusion: SCCPS is a low-frequency tumour with poor prognosis which rarely metastasizes to distant organs. We report a liver metastasis from SCCPS which was successfully treated with surgery.
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