Mores Ana Letícia, Lima de Araujo Caio Augusto, de Freitas Busnardo Fabio, Cardili Leonardo, Bertacchi João Guilherme, Santos-Silva Alan Roger, Brandão Thaís Bianca, Prado-Ribeiro Ana Carolina
Oral Diagnosis Department, Semiology and Oral Pathology Areas, Faculdade de Odontologia de Piracicaba da Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP, Brazil.
Division of Plastic Surgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
Oral Oncol. 2025 Aug;167:107438. doi: 10.1016/j.oraloncology.2025.107438. Epub 2025 Jun 28.
Distant metastasis of head and neck squamous cell carcinoma (HNSCC) most commonly occurs in the lungs, liver, and bones. Cutaneous metastases (CM) from HNSCC are rare, with an incidence ranging from 0.7 % to 2.4 %. These metastases can present as single or multiple nodules, or as erythematous macules in various anatomical sites, often mimicking dermatological conditions. CM is associated with a poor prognosis, with a median survival of 3 to 7 months following diagnosis.
We report a clinical case of a 57-year-old male with advanced-stage oropharyngeal squamous cell carcinoma who developed CM on his right arm during curative radiotherapy. The lesion, nodular and erythematous, measured approximately 4 x 4 cm and was associated with dorsal pain. Due to the progression of the primary disease to the skull base, palliative treatment was pursued, involving surgical excision of the skin lesions. At the time of surgery, the patient had one lesion on his right arm and two additional lesions on his right dorsal region. The patient passed away 45 days after the diagnosis of CM.
The diagnosis and management of CM are challenging. In patients with a history of HNSCC, the emergence of cutaneous lesions warrants prompt incisional biopsy for early diagnosis and appropriate treatment.
