Anatomical Extent, Presentation, and Outcomes of Distant Metastases to the Infratemporal Fossa: A Systematic Review

Background/Objectives: Distant metastasis to the infratemporal fossa (ITF) is rare and can mimic primary skull-base tumors. We systematically reviewed reported distant ITF metastases.

Methods

Following PRISMA 2020 (PROSPERO CRD420261422546), PubMed, Scopus, and Web of Science were searched through 12 June 2026, for reports of ITF metastasis from a distant primary tumor; direct extension from adjacent tumors was excluded. Data were summarized descriptively, and reports were appraised with the JBI Critical Appraisal Checklist for Case Reports.

Results

Seventeen reports (17 patients) were included (median age 59 years). The lung was the most frequent primary site (n = 4), followed by the kidney, colorectum, and thyroid (n = 3 each); adenocarcinoma was the most common histology (n = 7). Facial pain (n = 9) and numbness (n = 6) predominated. Bone destruction was reported in 12 patients, and the maxillary sinus (n = 7), orbit (n = 6), pterygopalatine fossa (n = 5), middle cranial fossa (n = 5), and cavernous sinus (n = 4) were involved. The median reported interval to ITF metastasis was 36 months; 11 metastases were metachronous, and 11 patients had other metastatic disease during the reported course. Five patients underwent regional resection or debulking; radiotherapy was reported in eight, radioiodine in three, and systemic drug treatment in nine. At last follow-up, 11 patients were alive, four had died, and status was unknown in two.