Oropharyngeal Squamous Cell Carcinoma Metastasis to Distal Skeletal Muscle on FDG PET/CT

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We present a case of a tongue squamous cell carcinoma (SCC) metastasizing to distal skeletal muscle detected on FDG PET/CT imaging. A 48-year-old man with locally recurrent tongue SCC underwent a restaging FDG PET/CT to investigate neck and unilateral leg pain. The PET scan showed large, intensely FDG-avid lesions in the right scalene and left hamstring muscles, which were biopsy proven as metastatic SCC. Skeletal muscle metastases from oropharyngeal SCCs are rare; however, PET/CT has allowed increased detection of atypical metastatic sites. Such cases support the consideration of metastasis for muscular lesions in head and neck cancer patients.

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