A RARE CASE REPORT OF BUCCAL MUCOSAL PRIMARY WITH BRAIN METASTASES

INTRODUCTION Buccal mucosal squamous cell carcinoma (BMSCC) is one of the most common form of oral cavity cancer associated with a high rate of locoregional recurrence and poor survival. Most frequent sites of distant metastasis from cancer of the oral cavity include lung, bone and liver and distant metastases are usually uncommon in buccal carcinoma. METHOD Case Report CASE PRESENTATION 45 years old male patient with no known comorbidity was treated with concurrent chemoradiotherapy for carcinoma of right buccal mucosa in 2013. After one year, patient reported with sudden right lower limb weakness and multiple episodes of seizures. MRI Brain revealed a space occupying lesion in left parietal region. Stereotactic biopsy from the lesion revealed metastatic squamous cell carcinomatous deposits. IHC study of brain lesion revealed positivity for EMA P63 and the pattern of staining favoured the diagnosis of metastatic squamous cell deposits of buccal mucosal origin. Patient was then given Whole Brain RT and was followed up with palliative chemotherapy. CONCLUSION Brain metastases though rare from a buccal mucosal- oral cavity cancer, it should be considered as a possibility and this case is presented for its rarity, being first of its kind .