39 Metastatic Genitourinary Tumors to the Head and Neck Region: A Contemporary Study

Introduction/Objective Epithelioid tumors in the head and neck (H&N) region include both primary and metastatic lesions, with cervical lymph nodes (CLNs) being a frequent metastatic site. While most metastases originate from upper aerodigestive tract primaries; genitourinary (GU) tumors can also metastasize to the H&N region. This study analyzes the most common GU tumors that spread to this area. Methods/Case Report A 14-year retrospective review of our H&N pathology database was conducted to identify patients with metastatic GU tumors. Clinical and pathologic data, including primary tumor site, histologic subtype, metastatic location, time-to-metastasis (TTM), treatment, and follow-up outcomes, were analyzed. Results Forty-two patients with metastatic GU tumors in the H&N region were identified: 6 (14%) germ cell tumors (GCT), 11 (26%) prostatic adenocarcinomas (PC), 22 (53%) renal cell carcinomas (RCC), and 3 (7%) urothelial carcinomas (UC). Among GCT patients (mean age 34), malignant teratoma was most common (67%), with all cases involving CLNs and a mean TTM of 10 years; most were without evidence of disease (67%) at follow-up. PC patients (mean age 71) most frequently had metastases to the spheno-clival region (46%) and CLNs (18%), with a mean TTM of 6.8 years; 46% died of disease. RCC patients (mean age 68) most often had clear cell subtype (73%), with metastases to thyroid (36%), CLNs (23%), parotid (18%), and gnathic bones (14%), and a mean TTM of 6.2 years; 46% were alive with disease. UC patients (mean age 71) had metastases to the ear, skull, and CLNs, with a mean TTM of 6.3 years. Conclusion Clear cell RCC was the most common GU tumor to metastasize to the H&N region, and CLNs were the most frequently involved site. Although rare, GU tumors should be considered in the differential diagnosis of unusual H&N neoplasms, particularly in patients with a history of GU malignancy or tumors of unknown primary.