Background:
Distant metastasis in oral squamous cell carcinoma (OSCC) indicates a poor prognosis, with the lungs the most frequently reported site for distant metastasis. Bone metastases in OSCC is rare compared to other malignancies. Here we report two distinct cases of bone metastases secondary to mandibular OSCC seen in our unit in the last 12 months.
Case one:
A 60-year-old female underwent a left segmental mandibulectomy, left neck dissection and flap reconstruction for a well-differentiated mandibular OSCC (pT3N1). She received adjuvant chemoradiotherapy. Three weeks post-chemoradiotherapy she developed a fluctuant lump on the right sternum, which was confirmed as metastatic SCC. The patient is currently receiving palliative chemoradiotherapy.
Case two:
A 73-year-old man had a pT4N0 moderately differentiated squamous cell carcinoma resected from the right mandible. Three months post-operatively, he developed bilateral neck of femur pathological fractures secondary to metastatic SCC. He was treated with palliative chemotherapy.
Conclusion:
These cases highlight the importance of comprehensive follow-up in OSCC patients. The management of bone metastases in OSCC remains focused on palliative care. Further case series and cohort studies are essential to better understand the patterns and progression of distant metastasis in OSCC, which can ultimately inform future treatment strategies.