Skip to main content
SpringerLink
Log in

Cavernous Sinus Metastasis in Patients of Head & Neck Squamous Cell Carcinoma: A Series of Five Rare Instances and Review of Literature

  • Clinical Report
  • Published:
Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Head and neck squamous cell carcinoma (HNSCC) exhibits a higher degree of local aggressiveness as compared to a tendency for distant metastasis. Cavernous sinus metastasis from HNSCC is exceptionally rare, with only a handful of cases reported worldwide. This case series presents five instances showcasing an unusual metastatic pattern of HNSCC to the cavernous sinus, documented over one year in a single tertiary cancer care centre in Northeast India. Typically, the treatment of cavernous sinus metastasis involves radiotherapy and chemotherapy with a palliative intent. Unfortunately, the prognosis for this entity is grim, with survival typically measured in months. Notably, all five patients were diagnosed with cavernous sinus metastasis manifested within 6 to 18 weeks post-completion of their definitive treatment. Among these five patients, four patients developed left-sided cavernous sinus metastasis and had the primary disease on the left side with nodal positivity and extranodal extension. Given the rarity of metastasis in this region, maintaining a vigilant follow-up is imperative for the early identification and treatment of these patients, especially in patients with left-sided primary with nodal positivity and extracapsular extension.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Duprez F, Berwouts D, De Neve W, Bonte K, Boterberg T, Deron P, Huvenne W, Rottey S, Mareel M (2017) Distant metastases in head and neck cancer. Head Neck 39(9):1733–1743

    Article  PubMed  Google Scholar 

  2. Ferlito A, Shaha AR, Silver CE et al (2001) Incidence and sites of metastases from head and neck cancer. ORL J OtorhinolaryngolRelat Spec 63:202–207

    Article  CAS  Google Scholar 

  3. Leemans CR, Tiwari R, Nauta JJP et al (1993) Regional lymph node involvement and its significance in the development of distant metastases in head and neck carcinoma. Cancer 71:452–456

    Article  CAS  PubMed  Google Scholar 

  4. Merino OR, Lindberg RD, Fletcher GH (1977) An analysis of distant metastases from squamous cell carcinoma of the upper respiratory and digestive tracts. Cancer 40:145–151

    Article  CAS  PubMed  Google Scholar 

  5. Sambit S, Nanda A, Patni, Gandhi AK, Rastogi M, Rath S, Sep (2020) vol -14(9): XD01–XD03

  6. Ahmad K, Yamokoshi C, Kim YH et al (1987) Involvement of cavernous sinus region by malignant neoplasms: reports of 5 cases. J Am Osteopath Assoc 87:504–508

    Article  CAS  PubMed  Google Scholar 

  7. Takami TM, Ohata k, Tsuyuguchi N, Mao Y, Inoue Y, Wakasa K et al (2002) Cavernous sinus metastasis from thyroid papillary adenocarcinoma. J Clin Neurosci 9:598–600

    Article  PubMed  Google Scholar 

  8. Reynard M, Brinkley JR Jr (1983) Cavernous sinus syndrome caused by rhabdomyosarcoma. Ann Ophthalmol 15:94–97

    CAS  PubMed  Google Scholar 

  9. Urban SD, Hall JM, Bentkover SH, Kadish SP (2002) Salivary duct carcinoma of minor salivary gland origin: report of a case involving the cavernous sinus. J Oral Maxillofac Surg 60:958–962

    Article  PubMed  Google Scholar 

  10. Chang PC, Fischbein NJ, McCalmont TH, Kashani-Sabet M, Zettersten EM, Liu AY et al (2004) Perineural spread of malignant melanoma of the head and neck: clinical and imaging features. Am J Neuroradiol 25:5–11

    PubMed  PubMed Central  Google Scholar 

  11. Curry M, Newlon J, Watson D (2001) Cavernous sinus metastasis from laryngeal squamous cell carcinoma. Otolaryngol Head Neck Surg 125(5):567–568

    Article  CAS  PubMed  Google Scholar 

  12. Bumpous JM, Maves MD, Gómez SM, Levy BK, Johnson F (1993) Cavernous sinus involvement in head and neck cancer. Head Neck 15:62–66

    Article  CAS  PubMed  Google Scholar 

  13. de Bree R, Mehta DM, Snow GB, Quak JJ (2001) Intracranial metastasis in patients with squamous cell carcinoma of the head and neck. Otolaryngol Head Neck Surg 124:217–221

    Article  PubMed  Google Scholar 

  14. Forner D, Wilke D, Rigby MH, Croul S, Mishra A, Massoud E, Clarke DB, Lamond N (2018) Cavernous sinus involvement in human papillomavirus associated oropharyngeal squamous cell carcinoma: case report of an atypical site of distant metastasis. Journal of otolaryngology - head & neck surgery Le Journal d’oto-rhino-laryngologie. et de chirurgie Cervicofac 47(1):32

    Google Scholar 

  15. Raúl González García J, Rodríguez Campo, Francisco J (2007) Díaz González, Cavernous sinus metastasis from oropharyngeal squamous cell carcinoma, Med Oral Patol Oral Cir Bucal ;12:E166–70

  16. Biju Azariah G, Babu R, Kumar C, Kainickal M, Rafi K, Ramadas (2017) Cavernous sinus metastasis from Carcinoma Buccal Mucosa - A Rare Presentation. Sch J Med Case Rep Dec 5(12):844–846

    Google Scholar 

  17. Anendd Jadhav A, Gupta N, Bhola, Karia H (2022) Remote metastasis of oral squamous cell carcinoma to cavernous sinus: a report of a rare case. Cureus 14(7):e27373

    PubMed  PubMed Central  Google Scholar 

  18. Harsha V, Mahalingam MD, Sunithi E, Mani MD, Bimal Patel MD, Krishna Prabhu, MCh M, Alexander DM, Girish M, Fatterpekar MD (2019) Geeta Chacko, MD, Imaging Spectrum of cavernous sinus lesions with histopathologic correlation. Radiographics 39:795–819

    Article  Google Scholar 

  19. Shelton J, Ramakrishnaiah R, Glasier C, Phillips P (2011) Cavernous sinus syndrome from an internal carotid artery aneurysm in an infant with tuberous sclerosis. J AAPOS 15(4):389–391

    Article  PubMed  Google Scholar 

  20. Chung C-P (2008) Jugular venous reflux. J Med Ultrasound 16(3):210–222

    Article  Google Scholar 

  21. D.lichtenstein R, Saifi R, Augarde S, Prin JM, Page (2001) I.Pipien, F.Jardin, the internal jugular veins are asymmetric. Usefulness of ultrasound before catheterization. Intensive care Med 27:301–305

    Article  Google Scholar 

  22. Svare A, Fossa SD, Heier MS (1988) Cranial nerve dysfunction in metastatic cancer of the prostate. Br J Urol 61:441–444

    Article  CAS  PubMed  Google Scholar 

  23. Laigle-Donadey F, Taillibert S, Martin-Duverneuil N et al (2005) Skull-base metasases. J Neurooncol 75:63–69

    Article  PubMed  Google Scholar 

  24. Iwai Y, Yamanaka K, Yoshimura M (2005) Gamma knife radiosurgery for cavernous sinus metastases and invasion. Surg Neurol 64(5):406–410

    Article  PubMed  Google Scholar 

  25. Kano H, Niranjan A, Kondziolka D, Flickinger JC, Lunsford LD (2009) The role of palliative radiosurgery when cancer invades the cavernous sinus. Int J Radiat Oncol Biol Phys 73(3):709–715

    Article  PubMed  Google Scholar 

Download references

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Radiation Oncology Dr B Borooah Cancer Institute, Guwahati, Assam, 781016, India

    Jyotiman Nath, Giridharan S & Mouchumee Bhattacharyya

  2. Department of Head and Neck Surgery, Dr B Borooah Cancer Institute, Guwahati, India

    Kaberi Kakati, Anupam Das & Siddhartha Basuroy

Authors
  1. Jyotiman Nath
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Giridharan S
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kaberi Kakati
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anupam Das
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mouchumee Bhattacharyya
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Siddhartha Basuroy
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Giridharan S.

Ethics declarations

Ethical Considerations

Written informed consent was obtained from the patients next of kin. Ethical committee approval not applicable as individual case study. Therapeutic care was decided after a multidisciplinary meeting. Consent was informed and written for therapeutic management.

Patient Consent

Written informed consent was obtained from the patients next of kin for the publication of report and relevant accompanying images.

Conflict of Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nath, J., S, G., Kakati, K. et al. Cavernous Sinus Metastasis in Patients of Head & Neck Squamous Cell Carcinoma: A Series of Five Rare Instances and Review of Literature. Indian J Otolaryngol Head Neck Surg (2024). https://doi.org/10.1007/s12070-024-04696-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12070-024-04696-7

Keywords

Search

Navigation