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Interobserver variability remains a major challenge for cytopathologists despite the development of standardized reporting and classification systems. Indeed, whereas moderate‐to‐good interobserver agreement is generally achievable when the differential diagnosis between benign and malignant entities is straightforward, high levels of variability make the diagnostic interpretation of atypical and suspicious samples not consistent. This review explores the landscape of interobserver agreement in cytopathology across different anatomical sites. [ABSTRACT FROM AUTHOR]

Head and neck squamous cell carcinoma (HNSCC) can, in rare instances, metastasize to the CNS, which is often associated with a poor prognosis. We present the case of a 65-year-old male with a history of HNSCC who developed two enhancing brain lesions: one in the right parietal region and another in the right insular region. Initially, the patient was managed with CyberKnife radiosurgery targeting both lesions. However, he later experienced neurological symptoms, including confusion, gait instability, and a left Jacksonian march, primarily attributed to the progression of the right parietal lesion. Given this symptomatic presentation, surgical resection of the lesion was performed to confirm the diagnosis and provide symptomatic relief. The surgical approach was selected based on the patient's clinical progression and imaging findings, with the goal of improving his quality of life. Despite surgical intervention, the patient's condition deteriorated, and he passed away seven months later. This case illustrates the complexity of treating CNS metastases from HNSCC, highlighting the challenges in surgical decision-making and the role of adjuvant therapies. The rarity of CNS metastases in HNSCC adds to the difficulty of management, underscoring the importance of a multidisciplinary approach. Further investigation is needed to develop standardized treatment protocols for such rare presentations. CNS metastases in HNSCC are uncommon and typically indicate a poor outcome. This case reinforces the need for ongoing research to enhance management strategies and improve patient survival in similar cases., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Corazzelli et al.)