Duodenal Metastasis from Head and Neck Cancer with an Intestinal Obstruction

Small intestinal metastasis from head and neck tumors is very rare. We herein report the case of a 71-yearold male with severe duodenal stricture due to duodenal metastasis from head and neck cancer whose duodenal stricture was conservatively relieved by endoscopic stenting. The patient had been treated with total laryngectomy and postoperative radiotherapy 13 months before visiting our department with complaints of a loss of appetite and vomiting. Esophagogastroscopy revealed a large submucosal tumor with severe obstruction in the duodenum. The histological findings of biopsy specimens showed moderately differentiated squamous cell carcinoma. He was thus diagnosed to have duodenal metastasis from the original supraglottic larynx cancer. Because his general condition was not sufficient to allow additional chemo-radiotherapy or surgery to be performed, conservative endoscopic stenting was employed to relieve the obstructive symptoms. After the stenting, the symptoms all immediately disappeared. When patients with head and neck tumors present with gastrointestinal bleeding and/or symptoms such as intestinal obstruction, endoscopic stenting appears to be useful for the palliative relief of such symptoms.