Squamous cell carcinoma of buccal mucosa with distant metastasis to brain

Head and neck squamous cell carcinoma (HNSCC) is known for increased recurrence rate and locoregional spread. Distant metastasis is less seen, while brain metastasis is a rare finding with <1% of HNSCC cases. The perineural route is the commonest mode of spread with symptoms of paresis, pain, vertigo, or neurological signs of cranial nerve involvement. Surgery with or without radiation therapy (RT) to the whole brain remains the mode of treatment in such cases. Here, we discuss a rare case of HNSCC, which metastasized to the brain within a few months of the completion of treatment of the primary tumor site. A combined treatment approach, which includes surgery, RT, and chemotherapy, is the mainstay of treatment to control locoregional spread.