title: Incidence of bone metastasis in carcinoma buccal mucosa.
abstract: BACKGROUND
  Head and neck cancer is a leading health problem in India due to the habit of chewing tobacco and bad oral and dental hygiene. Carcinoma buccal mucosa is more common and is 2.5% of all malignancies at our center. Most of the patients present in stage III and IV and the survival in these cases is not very good. Bone metastasis in advanced cases of carcinoma buccal mucosa is rarely reported in the world literature.
  
  
  METHODS
  We present here cases developing bone metastasis in carcinoma buccal mucosa in last 5 years. These patients were young with loco-regionally advanced disease where bone metastasis developed within 1-year of definitive treatment.
  
  
  RESULTS
  The flat bones and vertebrae were mainly involved and the survival was also short after diagnosis of metastasis despite the treatment with local Radiotherapy and chemotherapy.
  
  
  CONCLUSIONS
  The exact cause of metastasis cannot be proved, but the probability of subclinical seedling of malignant cells before the eradication of the primary tumor should be considered along with advanced local and nodal disease with high grade of tumor.
authors.affiliation: Department of Radiation Oncology, Roentgen - SAIMS Radiation Oncology Centre, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India.
authors.forename: Virendra
authors.initials: V
authors.lastname: Bhandari
keywords: Bone metastasis; buccal mucosa; squamous carcinoma