Carcinoma buccal mucosa with metastasis to left adrenal

Abstract

Buccal mucosa squamous cell carcinoma (BMSCC) is a rare but aggressive form of oral cavity cancer, associated with a high rate of locoregional recurrence and poor survival [1]. Patients with BMSCC have a worse stage-for-stage survival rate than the patients with other oral cavity sites [2]. It is not known to spread to distant organs. In these patients combined modality treatment incorporating surgery, adjuvant radiotherapy and chemotherapy should be considered as the best practice [3]. We report a case of locally advanced BMSCC which metastasised to left adrenal on presentation, picked up by PET-CT and later confirmed by CT-guided FNAC. An exhaustive pubmed search suggests that this is the first case of carcinoma buccal mucosa metastasising to adrenals, though rarely other sites of distant metastases have been reported; including brain, pericardial cavity, liver, lung, thyroid, bone and bone marrow [4]. We recommend a thorough metastatic workup including PET-CT for patients who present with advanced head and neck squamous cell carcinomas.