Vertebral metastases from oral squamous cell carcinoma

Purpose: The purpose of this study was to review the incidence and clinical presentation of vertebral metastases related to squamous cell carcinoma of the oral cavity. Patients and Methods: We conducted a retrospective review of our clinical experience with 597 cases of squamous cell carcinoma of the oral cavity. Results: Four patients with vertebral metastases were identified, accounting for 0.7% of the series. Thirteen vertebrae were involved in these 4 patients. All patients showed advanced cervical metastases as evidenced by several histologically positive nodes with extracapsular invasion when the ablative tumor specimen was examined. All patients displayed symptoms of their vertebral metastases, including severe pain, hypercalcemic somnolence, and flaccid paralysis of the lower extremities as part of the cauda equina syndrome. Conclusions: Vertebral metastases are rare forms of distant metastasis related to squamous cell carcinoma of the oral cavity. Bone pain is a symptom that should result in expedient radiographic examination in such patients, particularly when advanced cervical metastases are identified during the primary tumor surgery, which places the patient at risk for distant metastatic disease. (C) 2002 American Association of Oral and Maxillofacial Surgeons.