Background and importance: Intracranial metastases are rarely clinically diagnosed in patients with hypopharyngeal squamous cell carcinoma (SCC). In almost all cases, metastatic locations were found at the cavernous sinus and have been considered to develop as perineural invasions.
Clinical presentation: We present a case of hypopharyngeal SCC with distant intracranial metastases through hematogenous spreading. Two cerebral parenchymal metastases from the hypopharyngeal SCC were histologically analyzed in a 49-year-old male patient. The right temporal lesion was diagnosed by craniotomy and treated with radiotherapy. The right occipital lesion was treated with stereotactic radiosurgery (SRS).
Conclusion: To the best of our knowledge, there are no reports of hypopharyngeal SCC with cerebral metastases that developed via the hematogenous route. Radiotherapy along with surgery provides better outcomes, and SRS may improve the effect of treatments. Any subclinical neurological deficits should not be neglected, because awareness of this syndrome can lead to earlier diagnosis and alteration in treatment.