Tonsillar carcinoma metastatic to the spleen presenting as trauma: a case report.

BACKGROUND Cancers of the head and neck rarely metastasize to the spleen. To the best of our knowledge, there is no reported case of a tonsillar carcinoma metastasizing to the spleen. METHOD AND RESULTS This patient had a splenic capsular rupture likely related to his metastases that presented as a traumatic splenic injury. The patient had received neoadjuvant chemotherapy followed by concurrent chemoradiotherapy. Two months after completion of radiotherapy, he fell out of bed. The next day he had acute abdominal pain and hypotension. CT findings were consistent with splenic rupture, and he underwent splenectomy. Pathologic assessment of the specimen showed metastatic SCC. CONCLUSION New splemic lesions in patients with head and neck cancer should be investigated.