Jejunal perforation: an unusual presentation of metastatic cutaneous squamous cell carcinoma (SCC) in an immunosuppressed patient

BMJ Case Rep. 2017 Jan 6:2017:bcr2016216929. doi: 10.1136/bcr-2016-216929.

Abstract

We report the rare occurrence of a small bowel perforation secondary to a metastatic cutaneous squamous cell carcinoma (cSCC). A 70-year-old woman, who had previously undergone renal transplantation, presented with severe, sudden-onset abdominal pain. She was peritonitic on initial examination, with evidence of free intra-abdominal air on radiographic imaging. During an exploratory laparotomy, she was found to have a perforated jejunum secondary to disseminated metastases seen throughout her peritoneum. Following histopathological analysis, as well as further imaging studies, the primary malignancy was eventually identified as a cSCC on her upper back. Palliative care was started and the patient died 8 weeks following her initial presentation.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / etiology
  • Aged
  • Carcinoma, Squamous Cell / diagnosis
  • Carcinoma, Squamous Cell / secondary*
  • Diagnosis, Differential
  • Early Detection of Cancer
  • Endoscopy, Gastrointestinal
  • Fatal Outcome
  • Female
  • Humans
  • Immunosuppression Therapy
  • Intestinal Perforation / etiology*
  • Jejunal Diseases / etiology*
  • Kidney Transplantation
  • Peritoneal Neoplasms / diagnosis
  • Peritoneal Neoplasms / secondary*
  • Positron-Emission Tomography
  • Postoperative Complications
  • Skin Neoplasms / diagnosis*
  • Tomography, X-Ray Computed