Liver pecoma: perivascular epithelioid tumor. a case report

Abstract

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.