Metastatic oropharyngeal squamous cell carcinoma to the thyroid: A case report and review of literature

Am J Otolaryngol. 2024 Jul-Aug;45(4):104306. doi: 10.1016/j.amjoto.2024.104306. Epub 2024 Apr 16.

Abstract

Oral squamous cell carcinoma (OSCC) with metastasis to the thyroid gland is exceedingly rare, with limited documentation within the literature. Between 1984 and 2023, only 40 cases of head and neck squamous cell carcinoma (SCC) with thyroid gland metastasis were described in published literature. Herein, we present a distinctive case of second primary oropharyngeal SCC with metastasis to the thyroid, detected during surveillance positron emission tomography (PET) scanning subsequent to negative margin resection and radiation therapy for SCC originating from the hard palate. The underlying mechanisms overseeing metastasis remain elusive, with hypotheses ranging from lymphatic drainage routes connecting the thyroid gland and retropharyngeal lymph nodes to hematologic dissemination. The management of metastases to the thyroid gland is multifaceted, encompassing approaches ranging from lobectomy and total thyroidectomy to palliative interventions. We present this atypical case alongside supportive pathological and radiological findings and a comprehensive review of this rare clinical entity to offer insight into its diagnosis and management.

Keywords: Head and neck; Metastasis; Oral squamous cell carcinoma; Thyroid; cancer.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell* / diagnostic imaging
  • Carcinoma, Squamous Cell* / pathology
  • Carcinoma, Squamous Cell* / secondary
  • Carcinoma, Squamous Cell* / therapy
  • Humans
  • Male
  • Middle Aged
  • Neoplasms, Second Primary / diagnostic imaging
  • Neoplasms, Second Primary / pathology
  • Oropharyngeal Neoplasms* / diagnostic imaging
  • Oropharyngeal Neoplasms* / pathology
  • Oropharyngeal Neoplasms* / therapy
  • Positron-Emission Tomography
  • Thyroid Neoplasms* / diagnostic imaging
  • Thyroid Neoplasms* / pathology
  • Thyroid Neoplasms* / secondary
  • Thyroidectomy / methods