Diffuse thyroid metastasis from oropharyngeal squamous cell carcinoma

Thyroid metastasis (TM) from oropharyngeal squamous cell carcinoma (OPSCC) is exceedingly rare, with limited cases reported. Despite the vascular nature of the thyroid gland, its microenvironment does not favour metastatic spread.This case describes a male in his late 70s with p16-positive tonsillar SCC who presented with diffuse TM. The patient initially presented with dysphonia and weight loss, leading to a diagnosis of advanced SCC centred in the right tonsil with bilateral cervical lymphadenopathy. Further work-up revealed extensive thyroid involvement, confirmed by fine needle aspiration showing p16-positive SCC.This report highlights the need to consider uncommon sites of metastasis in patients with advanced OPSCC, especially those with human papillomavirus as a risk factor and underscores the importance of comprehensive diagnostic workups. Treatment options are tailored to individual cases given the rarity and this report highlights the importance of careful diagnosis and management of uncommon metastatic patterns.