An Uncommon Presentation of Single Bony Metastasis in Oropharyngeal Carcinoma: A Rare Case Report

Oropharyngeal Squamous Cell Carcinoma (OPSCC), a subtype of Head and Neck Squamous Cell Carcinoma (HNSCC), is known for its aggressive behaviour and tendency for local and distant metastasis. While lymphatic spread is the primary mode of metastasis, distant bone metastases, although rare, significantly impact patient prognosis and quality of life. This case report highlights an unusual occurrence of isolated clavicular bone metastasis in a 75-year-old male with OPSCC, presenting as a solitary lesion despite completing radiotherapy. The patient, with a history of tobacco use, initially underwent radical radiotherapy and concurrent chemotherapy for locally advanced OPSCC. Three months post-treatment, a follow-up Positron Emission Tomography (PET)/Computed Tomography (CT) scan revealed a metabolically active lesion in the right clavicle, indicative of bone metastasis. The rare nature of this metastasis site, combined with the absence of neurological or respiratory symptoms, underscores the need for vigilant monitoring and extended metastatic surveillance beyond typical sites. This report emphasises the importance of considering atypical metastatic patterns in OPSCC, particularly in non-Human Papilloma Virus (HPV)-associated cases, to facilitate early detection and timely intervention, ultimately improving patient outcomes and quality of life.