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. Conclusions: Distant ITF metastases may present with facial pain and cranial neuropathies. Prognosis is insufficiently characterized, and management should be individualized within a multidisciplinary team. The evidence is limited to case reports with incomplete reporting. No external funding was received.