Perforation of the Small Bowel Due To Metastasis from Tongue Cancer—a Case Report

Squamous cell carcinoma has a variety of modes of metastasis. Small-bowel metastasis from squamous cell carcinoma is extremely rare, and tongue cancer metastasizing to the small bowel has been previously reported in only one case in 2011 in Japan. We report a 60-year-old male diagnosed case of cancer tongue stage IV presented as intestinal perforation after the first cycle of palliative chemotherapy. An intraoperative frozen section from one of the mesenteric nodes was used to confirm M1 disease as the cause of perforation in mesenteric nodes as well as in the bowel wall. The perforated ileum was resected and ileostomy was done. We assume rapid infusion of 5-FU as a cause of rapid tumor necrosis and perforation. While handling stage IV oral SCC, this thing should be kept in mind.