Laryngeal squamous cell carcinoma with infradiaphragmatic presentation of skin metastases

Distant metastases in squamous cell carcinoma of the larynx have an incidence of 6.5-7.2%, and most commonly involve the lungs, liver and bone. Metastases to the skin are exceedingly rare, with only 30 cases reported in the literature. Skin metastases may represent the first clinical evidence of impending locoregional recurrence, suggest distant metastatic spread, or rarely, be the first sign of 'silent' laryngeal tumour. They are usually considered a poor prognostic sign and most often affect the supradiaphragmatic area, i.e. the head, neck, thorax or upper extremities. Infradiaphragmatic presentation of metastatic laryngeal squamous cell carcinoma is exceptional, with only four cases reported in the literature. Here we present another.