YIJOM-2705; No of Pages 6 Please cite this article in press as: Servato JP, et al. Metastatic tumours to the head and neck: retrospective analysis from a Brazilian tertiary referral centre, Int J Oral Maxillofac Surg (2013), http://dx.doi.org/10.1016/j.ijom.2013.05.020 Clinical Paper Head and Neck Oncology Metastatic tumours to the head and neck: retrospective analysis from a Brazilian tertiary referral centre J. P. Servato, L. F. B. de Paulo, P. R. de Faria, S. V. Cardoso, A. M. Loyola: Metastatic tumours to the head and neck: retrospective analysis from a Brazilian tertiary referral centre. Int. J. Oral Maxillofac. Surg. 2013; xxx: xxx–xxx. # 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved. J. P. Servato, L. F. B. de Paulo, P. R. de Faria, S. V. Cardoso, A. M. Loyola * Oral Pathology, School of Dentistry, Federal University of Uberla ˆ ndia, Brazil Abstract. Data regarding the development of head and neck metastases are limited, with the majority of the studies focusing on single cases affecting mainly the oral cavity and surrounding tissues. This study describes the incidence of head and neck metastases from primary tumours originating elsewhere. The medical records of selected patients were reviewed, and socio-demographic data as well as information about the localization of the primary tumours and their metastases to this region, treatment modalities employed, follow-up, and outcomes were collected. A total of 24 cases were found. The mean age at diagnosis was 52.1 Æ 17.6 years and the male to female ratio was 1:1.4. Most primary tumours were located in the lung and breast. The overall 1-, 2-, and 5-year survival rates were 63.0%, 39.1%, and 19.6%, respectively. Radiotherapy for the metastatic focus significantly prolonged the survival time of the patients (P = 0.048). Cervical lymph node metastases are a common event in patients with primary tumours growing elsewhere. Key words: metastatic tumours; head and neck metastasis; oral cavity metastasis; metastasis. Accepted for publication 29 May 2013 An experienced oral pathologist will examine a number of biopsy samples taken from tumoral lesions affecting the head and neck region; these are normally expected to be squamous cell carcinoma, the most frequent malignant lesion in this region. During the microscopic examina- tion, the pathologist may discover a tumoral lesion, the morphology of which is believed to be metastatic, originating from a primary tumour growing at a dis- tant site. 1 Even taking into consideration the rarity of this diagnosis and its chal- lenges, an experienced pathologist should make an appropriate diagnosis of the metastatic lesion, since its presence in this region appears to have a high impact on the prognosis and survival time of the patient. 2–8 It is know that 1% of all head and neck malignancies are metastases of primary tumours developing elsewhere. 9 However, one study that investigated the incidence of oral and craniofacial metastases found 2.39% of lesions were metastases, indicat- ing that their occurrence in this region may be much higher than expected. 6 These discrepancies could be explained by a number of factors, but one that is very important is the number of patients included in each study. Moreover, there have been few reports evaluating the inci- dence of metastases with regards to all regions of the head and neck, such as cervical lymph nodes, salivary glands, and thyroid, and the majority of studies Int. J. Oral Maxillofac. Surg. 2013; xxx: xxx–xxx http://dx.doi.org/10.1016/j.ijom.2013.05.020, available online at http://www.sciencedirect.com 0901-5027/000001+06 $36.00/0 # 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.