RESUMEN
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.
Asunto(s)
Carcinoma de Células Escamosas , Neoplasias Orofaríngeas , Neoplasias de la Tiroides , Humanos , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/secundario , Neoplasias de la Tiroides/diagnóstico por imagen , Neoplasias Orofaríngeas/patología , Neoplasias Orofaríngeas/terapia , Neoplasias Orofaríngeas/diagnóstico por imagen , Masculino , Carcinoma de Células Escamosas/secundario , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/terapia , Carcinoma de Células Escamosas/diagnóstico por imagen , Tomografía de Emisión de Positrones , Persona de Mediana Edad , Tiroidectomía/métodos , Anciano , Neoplasias Primarias Secundarias/patología , Neoplasias Primarias Secundarias/diagnóstico por imagenRESUMEN
Myoepithelial carcinoma is a rare disease of the head and neck, with only a handful of cases reported occurring within the external auditory canal, middle ear, and mastoid. The patient discussed is a 67-year-old male with a prior history of a bilateral tympanomastoidectomy for cholesteatoma and a prior history of left parotidectomy and adjuvant radiation for pleomorphic sarcoma. Three years after the parotidectomy, the patient presented with contralateral ear fullness. During an intraoperative examination, a fibrous mass was encountered, which revealed an invasive salivary gland neoplasm, myoepithelial subtype. Definitive treatment consisted of a right radical mastoidectomy, temporal bone resection, and canal closure with adjuvant chemoradiation. This case serves to contribute to the established literature regarding this particular subtype of head and neck cancer, as well as provide the reader with a brief review of this rare entity.