Spontaneous Fracture Of The Clavicle From Laryngeal Carcinoma Distant Metastasis

Distant metastases of laryngeal carcinoma are rare and their diagnosis and management are still a challenge for the Otolaryngologist. We present a case of an 56-year-old man with a history of total laryngectomy and selective neck dissection (Level II, III) in the right side two years ago, who presented to our Hospital with a swelling, redness and pain on his left clavicle, without a history of trauma in the above area. Radiological examinations revealed a spontaneous fracture of the left clavicle. Patient underwent surgical procedure of the above area and biopsies were taken from the surgical field and the skin. Metastatic infiltration of the overlying skin cancelled the decision for postoperative radiotherapy or chemotherapy because the closure of the wound would be at risk. Patient discharged having only palliative treatment. We present the prognostic factors, location and management of distant metastases. Surgeons have to keep in mind an index of high risk for distant metastasis based on the previous surgical procedure, the histology and staging of the carcinoma. This could be useful for early diagnosis of metastatic disease in order to improve the quality of life of these patients.