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Pineal gland metastasis of auricular squamous cell carcinoma: an unusual case and literature review Background. The pineal gland is an unusual site for metastasis, and most metastatic pineal lesions are asymptomatic. Metastases to the pineal gland from skin cancer are extremely rare and reported mostly on autopsy series. Squamous cell carcinoma is the second most common type of skin cancer that occurs on the external ear. Auricular squamous cell carcinoma is an invasive and destructive tumour, and may cause hearing problems by local extension to the auditory canal. The vast majority of squamous cell carcinomas of the auricular region metastasize to the lung, bone, and brain. Case report. We report the case of a patient with a giant squamous cell carcinoma of the auricula with extension deep into the temporal bone, metastasizing to the lung and pineal gland. Conclusions. A metastasis should be considered as a possible cause, when encountering a mass in the pineal region, especially in elderly patients with a known primary cancer.