Horner Syndrome Secondary to Metastatic Squamous Cell Carcinoma in the Neck: A Case Series

Horner syndrome caused by metastatic squamous cell carcinoma of the head and neck is not common, and when diagnosed, may have serious clinical implications. We aim at highlighting the clinical significance of this finding.

We retrospectively reviewed charts of 6 patients with Horner syndrome secondary to metastatic head and neck squamous cell carcinoma (HNSCC) in the neck.

All 6 patients had pathologically confirmed nodal metastatic HNSCC. There was one unknown primary and in the remaining 5 patients the primary tumor was identified in the oropharynx, larynx, and oral cavity. Three patients died within 1 month of diagnosis, before initiation of any treatment. One patient received radiation only while 2 patients received chemoradiation with cisplatin as the tumors were unresectable given carotid sheath involvement. Median survival was 4.5 months. Only 1 out of the 6 patients survived and had complete resolution of Horner syndrome after treatment.

This is the first case series of neck metastasis from mucosal HNSCC as an unusual cause of Horner syndrome and is usually associated with very poor prognosis.