Hidden Intracranial Challenge: Intracranial Metastases in Oral Squamous Cell Carcinoma – A Report of Two Cases

Squamous cell carcinoma is the most common malignant tumour of epithelial origin in the oral cavity. Distant metastasis is uncommon but loco regional spread is defining feature of OSCC. Distant metastasis most commonly affects lungs, bone and liver, while involvement of brain ( cavernous sinus/pituitary gland) is extremely rare. However non head and neck lesions like those from different solid and hematologic malignancies (breast, lung, bone, kidney prostate and colon) results in metastasis to sellar area. Visual symptoms are the most common primary manifestation in these scenarios. The posterior pituitary is most commonly affected than anterior. Tumour spread to pituitary can occur even after successful primary treatment. Metastasis to cavernous sinus (CS) from head and neck squamous cell carcinoma (HNSCC) is very rare. The rare and inaccurate presentation of CS metastasis from hnscc makes identification and treatment difficult. Using representative clinical cases as guidance we present two clinical reports of cranial metastases. Future studies are needed to determine the exact molecular mechanism of metastasis to pituitary region.