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C. R. Leemans, R. Tiwari, J. J. P. Nauta, I. van der Waal and G. B. Snow, “Regional Lymph Node Involvement and Its Significance in the Development of Distant Metastasis in Head and Neck Carcinoma,” Cancer, Vol. 71, No. 2, 1993, pp. 452-456.
http://dx.doi.org/10.1002/1097-0142(19930115)71:2<452::AID-CNCR2820710228>3.0.CO;2-B

has been cited by the following article:

• TITLE: Squamous Cell Carcinoma of the Oropharynx Presenting with Distant Metastasis to the Ulna

  AUTHORS: Preetham Achoor Puthukudy, Musarrat Feshan

  KEYWORDS: Squamous Cell Carcinoma; Oropharyngeal Squamous Cell Carcinoma (OPSCC); Oropharynx; Distant Metastasis; Ulna; Head and Neck Cancer; Pathological Fracture

  JOURNAL NAME: International Journal of Otolaryngology and Head & Neck Surgery, Vol.2 No.6, November 8, 2013

  ABSTRACT: Squamous cell carcinomas are the commonest malignancies of the head and neck. Metastases from stage III and stage IV tumors occur most commonly in the cervical lymph nodes. The incidence of distant metastases occurring from such advanced tumors is anywhere between 10% and 40%. Distant metastases occur most commonly to the lungs followed by the bone and liver. The bone metastasis occurs commonly in the axial skeleton. We report a rather unusual case of squamous cell carcinomas from the Head and Neck region in a 77-year-old male metastasizing to the ulna. This case is even more interesting because the presenting symptom was a pathological fracture of the ulna for which he had reported to the orthopedic department. The immunohistochemistry of the metastatic tumor had shown an unmistakable squamous cell carcinoma with positive cytokeratin elements within the tumor. He referred to the ENT department where he was diagnosed with T2N0M1 squamous cell carcinoma of the oropharynx. The patient was treated with internal fixation and bone cementing for the metastatic lesion, and primarily treated with chemoradiation.