Rare femoral metastasis in late recurrent squamous cell carcinoma of the oral cavity

Background/Aim: Squamous cell carcinoma (SCC) is the most frequent carcinoma when dealing with malignant tumors of the oral cavity. SCC of the head and neck show cervical lymphatic metastasis, which is the most important prognostic factor for the long-term outcome of these patients. Hematogenous spread of this entity is rare, especially distant osseous metastasis. Therefore, the therapy for SCC typically consists of surgical tumor resection, neck dissection and plastic reconstruction. Most recurrences occur within the first two years postoperatively. This results in the need for close tumor follow-up.

Case report

The present case report describes a 79-year-old female suffering from a recurrent SCC of the oral cavity 19 years postoperatively firstly noticed through symptomatic osseous metastasis of the right femur. Trial excision of the right femur revealed the finding of a metastatic squamous cell carcinoma. The patient received palliative radiation therapy.

Conclusion

Osseous metastasis of SCC to the femur is rare. What is remarkable about this case report is the time span of 19 years between primary curative treatment, unremarkable follow up and the presence of metastatic late recurrence. Therefore long-term close follow-up in the treatment of oral cavity SCC in an interdisciplinary context is crucial.