Ophthalmic Metastasis in Squamous Cell Carcinoma of Head and Neck: A Study on Two Patients

Primary squamous cell carcinoma of head and neck usually metastasizes to the regional lymph node, lung, and bone. Ophthalmic metastasis in squamous cell carcinoma of head and neck is uncommon. Most of the ophthalmic metastasis is due to the carcinoma of the breast and lung. Squamous cell carcinoma of the oral cavity with metastasis to the eye has not yet been documented. We are presenting herewith two cases of carcinoma buccal mucosa that had ophthalmic metastasis. One patient had carcinoma left buccal mucosa, which was treated with left marginal mandibulectomy with pectoralis major myocutaneous flap and neck dissection followed by radiotherapy. He was asymptomatic for 11⁄2 year, subsequently he presented with choroid, lung and bone metastasis. The other patient was diagnosed as carcinoma right buccal mucosa, which was subsequently treated with segmental mandibulectomy with supraomohyoid neck dissection, followed by radiotherapy. He was asymptomatic for 6 months. Subsequently, he presented with metastasis to the left orbit. Both the patients were treated with radiation with palliative intent to the eye and were symptomatically improved. The clinical presentation, diagnosis and treatment of carcinoma buccal mucosa with ophthalmic metastasis are discussed here with the review of literature due to its rarity and for future documentation.