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Observation
August 27, 2020

An Unlikely Cause of Headaches and Temporomandibular Joint Pain in a Young Woman

Author Affiliations
  • 1SUNY Upstate, Department of Otolaryngology–Head and Neck Surgery, Syracuse, New York
  • 2SUNY Upstate, School of Medicine, Syracuse, New York
JAMA Otolaryngol Head Neck Surg. 2020;146(11):1083-1085. doi:10.1001/jamaoto.2020.2182

Skull base involvement from locally invasive head and neck cancer is not uncommon; however, isolated skull base metastasis (SBM) is extraordinarily rare. Cases of SBM have been reported in patients with breast or prostate cancers and, in rare instances, in patients with advanced cervical cancer. Cervical cancer, the fourth most common cancer among women, is caused by the human papilloma virus (HPV), the most common sexually transmitted infection (STI) worldwide.1 In fact, it is estimated that 80% to 90% of women in the US will be infected with 1 strain of HPV by the age of 45 years.2,3 Although routine screening has reduced the incidence of cervical cancer in the US, it remains a leading cause of cancer-related death. The main routes of spread are through direct extension and to pelvic and para-aortic lymph nodes via the lymphatic system. The most common sites of metastasis are the lungs, extrapelvic nodes, and the liver. To our knowledge, isolated SBM has been reported in fewer than 10 patients.

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