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Vettori E, Borella A, Costantinides F, Rizzo R, Maglione M. Mandibular metastasis of pulmonary adenocarcinoma: How unexpected could it be? Gerodontology 2024; 41:283-288. [PMID: 37496280 DOI: 10.1111/ger.12707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVE Metastatic tumours of bone must be considered in all patients with unexplained bone pain and particularly in patients who present with a known cancer, localised pain at multiple sites, and radiographic findings suggestive of metastasis. The purpose of this report was to present a case of a pathological fracture of the mandible as a consequence of metastatic pulmonary adenocarcinoma. MATERIALS AND METHODS In July 2018 a 68-year-old male patient was hospitalised because of pulmonary adenocarcinoma and attended our department for an oral maxillo-facial evaluation. He complained of pain and swelling in the right temporomandibular region resulting in a reported functional limitation. An Orthopantomogram (OPG) demonstrated a right intracapsular condylar compound fracture associated with an osteolytic lesion at the condyle base with jagged margins. Subsequently, a CT scan with contrast of the maxillo-facial complex and a fine-needle aspiration of the lesion was performed. RESULTS CT images showed the presence of a right mandibular condyle fracture associated with a large osteolytic lesion which confirmed the pathological nature of the fracture. Fine-needle aspiration of the lesion confirmed its metastatic nature. It was not possible to proceed with a mandibular resection due to the critical clinical condition of the patient who died in September 2018. CONCLUSION Lung cancer frequently produces lytic-type metastasis, sometimes even in the jaw. In patients with an established diagnosis of lung cancer, any radiolucent lesion of the jaw or an unexplained painful symptomatology to the oro-maxillo facial complex should be placed in differential diagnosis with metastasis of the primary tumour.
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Affiliation(s)
- Erica Vettori
- Unit of Maxillofacial Surgery and Stomatology, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Alberto Borella
- Unit of Maxillofacial Surgery and Stomatology, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Fulvia Costantinides
- Unit of Maxillofacial Surgery and Stomatology, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Roberto Rizzo
- Unit of Maxillofacial Surgery and Stomatology, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Michele Maglione
- Unit of Maxillofacial Surgery and Stomatology, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
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Atarbashi-Moghadam S, Atarbashi-Moghadam F, Niazmand M, Shahrabi-Farahani S. Metastatic sarcomas of the oral cavity: A systematic review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101656. [PMID: 38738551 DOI: 10.1016/j.jormas.2023.101656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/04/2023] [Accepted: 10/19/2023] [Indexed: 05/14/2024]
Abstract
Oral metastatic sarcomas (OMSs) occur only occasionally, and information about their characteristics is based on the restricted number of cases reported in the literature. This study aims to systematically review the English literature to recognize the clinicopathologic characteristics of OMSs. An electronic search was performed in PubMed Central and Scopus databases. The search included all the published articles (human case reports and case series) up till April 2023, with no time restrictions. OMSs were slightly more prevalent in males in their fifth to seventh decades of life. However, a high percentage of OMSs has been reported in the second decade of life. Lower extremities, breasts and uterus are the most common primary origin of metastatic sarcoma. Gingiva and mandible were common locations in the oral cavity for metastatic deposits. Generally, they demonstrated widespread affliction. The mean time interval between primary tumor detection and diagnosis of the oral metastasis was about 33.54 ± 36.19 months. Death was reported in 83 patients (67.48 %) with a mean survival rate of 7.98 ± 10.30 months. The most common microscopic tumor types were leiomyosarcoma (n = 21, 17 %), followed by angiosarcoma (n = 20, 16.26 %) and osteosarcoma (n = 18, 14.63 %). In conclusion, while oral metastases of sarcomas are not common, those should be considered in the differential diagnosis of the oral lesions. Although OMSs show a high occurrence in the 7th decade of the life, the average age of patients with oral involvement is lower than the overall metastatic lesions. OMSs may present as widespread disease with poor prognosis.
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Affiliation(s)
- Saede Atarbashi-Moghadam
- Department of Oral Pathology, Associate Professor of Oral and Maxillofacial Pathology, College of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fazele Atarbashi-Moghadam
- Department of Periodontics, Associate Professor of Periodontics, College of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Dental Research Center, Research Institute of Dental Sciences, College of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maral Niazmand
- Research Center, General Dentist, Dental School Shahid Beheshti, University of Medical Sciences, Tehran, Iran
| | - Shokoufeh Shahrabi-Farahani
- Department of Diagnostic Sciences, Associate Professor and Director of Oral and Maxillofacial Pathology, College of Dentistry, University of Tennessee Health Science Center, 875 Union Avenue, Memphis, TN 38163, USA.
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Murahashi M, Ntege EH, Ide K, Maruyama N, Shirakawa J, Koyama H, Kawano T, Goto T, Shimizu Y, Nishihara K, Nakamura H. Metastatic gallbladder cancer presenting as numb chin syndrome: A case report and literature review. Biomed Rep 2024; 20:61. [PMID: 38476609 PMCID: PMC10928479 DOI: 10.3892/br.2024.1749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/04/2023] [Indexed: 03/14/2024] Open
Abstract
Gallbladder cancer (GBC) is an uncommon malignancy that is highly aggressive in the advanced stages. However, it rarely metastasizes to the mandible. Numb chin syndrome (NCS) is a rare neurological manifestation associated with various underlying causes, including occult primary cancers and distant metastases. It is often considered to be a significant indicator of malignancy, and thorough investigation is essential in the presence of unclear etiology. The current study reported on the case of a 69-year-old Japanese woman who presented with numbness and mild pain in the lower lip and chin area for three months. No other systemic symptoms were observed. Immunocytochemical examination revealed the presence of an adenocarcinoma and TNM staging as per the Union for International Cancer Control and the American Joint Committee on Cancer guidelines confirmed stage IVb GBC. Comprehensive full-body positron emission tomography-computed tomography examination using 18F-fluoro-2-deoxy-D-glucose revealed additional bone and soft-tissue metastases. Palliative chemotherapy and radiation treatment were initiated based on the advanced stage of disease at the time of diagnosis. However, the patient succumbed to multiple organ failure six months later. The simultaneous occurrence of GBC, mandibular metastasis and NCS is rare and associated with poor prognosis. Despite the widespread nature of the disease, it can often manifest as non-specific oral symptoms without any systemic indications. The current study emphasizes the critical importance of timely confirmatory testing for accurate diagnosis and initiation of appropriate management for such complex conditions.
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Affiliation(s)
- Makoto Murahashi
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of The Ryukyus, Nishihara, Okinawa 903-0215, Japan
- Department of Oral and Maxillofacial Surgery, Okinawa Red Cross Hospital, Naha, Okinawa 902-8588, Japan
| | - Edward Hosea Ntege
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of The Ryukyus, Nishihara, Okinawa 903-0215, Japan
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Kentaro Ide
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of The Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Nobuyuki Maruyama
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of The Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Jumpei Shirakawa
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of The Ryukyus, Nishihara, Okinawa 903-0215, Japan
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Miyazaki, Kiyotake, Miyazaki 889-1692, Japan
| | - Hiroki Koyama
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of The Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Toshihiro Kawano
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of The Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Takahiro Goto
- Department of Oral and Maxillofacial Surgery, Okinawa Red Cross Hospital, Naha, Okinawa 902-8588, Japan
| | - Yusuke Shimizu
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Kazuhide Nishihara
- Department of Oral and Maxillofacial Surgery, Okinawa Red Cross Hospital, Naha, Okinawa 902-8588, Japan
| | - Hiroyuki Nakamura
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of The Ryukyus, Nishihara, Okinawa 903-0215, Japan
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Owosho AA, Aguirre SE, Dayo AF, Omolehinwa TT, Shintaku WH. Radiographic Orofacial Findings of Systemic Diseases. Dent Clin North Am 2024; 68:409-427. [PMID: 38417998 DOI: 10.1016/j.cden.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
This article discusses the orofacial clinicoradiographic features of systemic diseases that manifest in the orofacial region. The systemic diseases discussed are grouped into the following: autoimmune diseases, endocrine diseases, bone diseases, hematologic diseases, syndromes, and malignancies. The radiographic manifestation ranges from radiolucent bony destruction, increased bone density, calcification, thinning of cortical plate, loss of trabeculation, missing teeth, and supernumerary teeth. It is imperative for clinicians to be cognizant of these findings, as they may be the first manifestation of these systemic diseases.
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Affiliation(s)
- Adepitan A Owosho
- Department of Diagnostic Sciences, College of Dentistry, The University of Tennessee Health Science Center, Memphis, TN, USA.
| | - Sarah E Aguirre
- Department of Diagnostic Sciences, College of Dentistry, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Adeyinka F Dayo
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, PA, USA
| | - Temitope T Omolehinwa
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, PA, USA
| | - Werner H Shintaku
- Department of Diagnostic Sciences, College of Dentistry, The University of Tennessee Health Science Center, Memphis, TN, USA
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Omami G, Yeoh M. Malignant Lesions of the Oral Region. Dent Clin North Am 2024; 68:319-335. [PMID: 38417993 DOI: 10.1016/j.cden.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
This article focuses on the radiographic presentations of various malignant conditions that affect the oral region and delineates the role of CT, MR imaging, and PET in oral cancer imaging.
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Affiliation(s)
- Galal Omami
- Division of Oral Diagnosis, Oral Medicine, and Oral Radiology, Department of Oral Health Practice, University of Kentucky College of Dentistry, 770 Rose Street, MN320, Lexington, KY 40536, USA.
| | - Melvyn Yeoh
- Division of Oral and Maxillofacial Surgery, University of Kentucky College of Dentistry, 770 Rose Street, D-528, Lexington, KY 40536, USA
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Upadhyay AK, Kumar A, Shahab T, Sharma S, Saha BK, Narayan R. Squamous cell carcinoma of breast metastasising to upper lip. BMJ Case Rep 2024; 17:e259653. [PMID: 38442962 PMCID: PMC11107084 DOI: 10.1136/bcr-2024-259653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2024] [Indexed: 03/07/2024] Open
Abstract
Breast cancer is a heterogeneous set of carcinomas comprising a subgroup of invasive ductal carcinomas and numerous infrequent subtypes. Primary squamous cell carcinoma (SCC) breast is sporadic, accounting for less than 0.1% of all invasive subtypes. Primary metastases to soft tissues of the oral cavity are incredibly rare, amounting to 0.1% of oral malignancies. Diagnosing metastasis to the oral cavity is an enigma to clinicians without pathognomonic signs and symptoms. Here, we report a case of SCC breast, who developed metastatic deposits in the left upper lip after a disease-free survival of 1 year. There are no reports of SCC breast metastasising to the oral cavity, and probably, this is the first such case getting reported. The survival of such patients is abysmal, with most cases surviving less than a year post diagnosis. While treating patients with a history of malignancy, a high degree of clinical presentiment is required.
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Affiliation(s)
| | - Abhishek Kumar
- Nuclear Medicine, Tata Main Hospital, Jamshedpur, Jharkhand, India
| | - Tarannum Shahab
- Medical Oncology, Tata Main Hospital, Jamshedpur, Jharkhand, India
| | - Swati Sharma
- Dentistry, Tata Main Hospital, Jamshedpur, Jharkhand, India
| | - Bijan Kumar Saha
- Department of Surgical Oncology, Tata Main Hospital, Jamshedpur, India
| | - Radhika Narayan
- Department of Pathology, Tata Main Hospital, Jamshedpur, India
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Ferragina F, Sottile AR, Cristofaro MG. Unusual presentation of pulmonary adenocarcinoma metastases in the mandibular condyle: A case report. Int J Surg Case Rep 2023; 113:109058. [PMID: 37992667 DOI: 10.1016/j.ijscr.2023.109058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/08/2023] [Accepted: 11/11/2023] [Indexed: 11/24/2023] Open
Abstract
INTRODUCTION Mandibular bone metastases should be suspected in all patients with temporomandibular joint disorder symptoms and lung cancer history. The purpose of this report is to present a case of metastasis to the mandibular condyle following pulmonary adenocarcinoma. CASE PRESENTATION In December 2020, a 71-year-old patient was evaluated by the Department of Maxillofacial Surgery for the presence of a large osteolytic lesion in the left mandibular condyle. There were no changes to the face or occlusion, and mandibular movements were preserved. After surgical removal, histology revealed pulmonary adenocarcinoma metastasis. DISCUSSION To date, only 7 cases of condylar metastases are described by lung cancer. This pathology's clinical and radiological features are almost always shaded and not specific. CONCLUSION This study also focuses on rare conditions, such as metastases to the mandibular condyle. It also stresses the importance of a multidisciplinary approach both in the diagnostic and therapeutic process.
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Affiliation(s)
- Francesco Ferragina
- Department of Experimental and Clinical Medicine, Unit of Maxillofacial Surgery, "Magna Graecia" University, Viale Europa, 88100 Catanzaro, Italy.
| | - Angelo Ruggero Sottile
- Department of Experimental and Clinical Medicine, Unit of Maxillofacial Surgery, "Magna Graecia" University, Viale Europa, 88100 Catanzaro, Italy
| | - Maria Giulia Cristofaro
- Department of Experimental and Clinical Medicine, Unit of Maxillofacial Surgery, "Magna Graecia" University, Viale Europa, 88100 Catanzaro, Italy
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Kirschnick LB, Schuch LF, Gondak R, Rivero ERC, Gomes APN, Etges A, Tarquinio SBC, Mesquita RA, Caldeira PC, da Costa AAS, Mendonça EF, Dos Santos JN, Smit C, Robinson L, Tager EMJR, Mosqueda-Taylor A, Pontes HAR, de Andrade BAB, Fonseca TC, Abrahão AC, Agostini M, Romañach MJ, Alves FA, Jaguar GC, de Mendonça NF, Pinto MBR, da Silva LC, Lopes MA, Vargas PA, van Heerden W, Abreu LG, Martins MD, Vasconcelos ACU. Clinicopathological Features of Metastasis to the Oral and Maxillofacial Region-Multicenter Study. Head Neck Pathol 2023; 17:910-920. [PMID: 37902929 PMCID: PMC10739623 DOI: 10.1007/s12105-023-01588-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 09/29/2023] [Indexed: 11/01/2023]
Abstract
BACKGROUND This study aimed to investigate the clinicopathological features of metastases in the oral and maxillofacial regions. METHODS In this retrospective study, biopsy records were obtained from referral centers for oral and maxillofacial diagnosis in Brazil, Guatemala, Mexico, and South Africa. RESULTS A total of 120 cases were evaluated. Of these, 53.78% affected female patients, with a mean age of 57.64 years. Intraosseous lesions were more frequent, particularly in the posterior region of the mandible (49.58%). Clinically, most cases presented with symptomatic swelling, with an average evolution time of 25 months. The clinical diagnostic hypothesis in most instances was that of a malignant lesion. Breast cancer was the most common primary tumor location in females, while lung origin was most common in males. In most cases, the primary cancer was an adenocarcinoma (44.73%). The follow-up period was available for 29 cases, and out of these, 20 had died due to the disease. CONCLUSION Although this is a rare condition, clinicians should be aware that any oral lesions have the possibility of being metastatic, particularly in individuals with a previous history of cancer. The findings from this study could assist clinicians in prompt diagnosing these lesions and subsequent conducting oncologic assessments and treatment.
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Affiliation(s)
- Laura Borges Kirschnick
- Oral Diagnosis Department, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Lauren Frenzel Schuch
- Oral Diagnosis Department, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Rogério Gondak
- Department of Pathology, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | | | - Ana Paula Neutzling Gomes
- Diagnostic Center for Oral Diseases, Dental School, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Adriana Etges
- Diagnostic Center for Oral Diseases, Dental School, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | | | - Ricardo Alves Mesquita
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Patrícia Carlos Caldeira
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | - Jean Nunes Dos Santos
- Department of Oral Pathology, Postgraduate Program in Dentistry and Health, School of Dentistry, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Chané Smit
- Department of Oral and Maxillofacial Pathology, School of Dentistry, University of Pretoria, Pretoria, South Africa
| | - Liam Robinson
- Department of Oral and Maxillofacial Pathology, School of Dentistry, University of Pretoria, Pretoria, South Africa
| | - Elena María José Román Tager
- Oral Diagnosis Department, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
- Pathology Section, Clinical Center of Head and Neck/Hospital Herrera Llerandi, Guatemala City, Guatemala
| | | | | | | | - Thamyres Campos Fonseca
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Aline Corrêa Abrahão
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Michelle Agostini
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Mário José Romañach
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Fábio Abreu Alves
- Stomatology Department, A. C. Camargo Hospital, São Paulo, SP, Brazil
| | | | | | | | - Luan César da Silva
- Oral Diagnosis Department, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Márcio Ajudarte Lopes
- Oral Diagnosis Department, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Pablo Agustin Vargas
- Oral Diagnosis Department, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Willie van Heerden
- Department of Oral and Maxillofacial Pathology, School of Dentistry, University of Pretoria, Pretoria, South Africa
| | - Lucas Guimarães Abreu
- Department of Child and Adolescent Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Manoela Domingues Martins
- Oral Diagnosis Department, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Ana Carolina Uchoa Vasconcelos
- Diagnostic Center for Oral Diseases, Dental School, Universidade Federal de Pelotas, Pelotas, RS, Brazil.
- Centro de Diagnóstico das Doenças da Boca - CDDB, Faculdade de Odontologia, Universidade Federal de Pelotas, Rua Gonçalves Chaves, 457, sala 607 , Pelotas, RS, Brazil.
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Makoto M, Ntege EH, Kazuhide N, Kentaro I, Jumpei S, Nobuyuki M, Toshihiro K, Yusuke S, Hiroyuki N. Metastatic colon carcinoma in the maxilla: Highlighting the importance of perioperative oral management: A case report. Mol Clin Oncol 2023; 19:83. [PMID: 37745262 PMCID: PMC10512196 DOI: 10.3892/mco.2023.2679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 08/02/2023] [Indexed: 09/26/2023] Open
Abstract
Metastatic colorectal carcinoma involving the maxilla is a rare phenomenon, and existing literature regarding the significance of perioperative oral function management (POM) in managing such cases is limited. In the present case report the clinical details of a 58-year-old male referred to the oral and maxillofacial department for POM. The patient had previously undergone segmental bowel resection due to stage IIIb colon cancer. A comprehensive approach encompassing a thorough medical history, meticulous physical examination, radiographic imaging and immunohistopathology was employed, and a definitive diagnosis of metastatic adenocarcinoma in the left maxillary gingiva originating from a colorectal carcinoma was reached. Additionally, concomitant metastases were detected in the lungs and liver. Despite the daunting prognosis associated with the metastases in the oral cavity, the patient's quality of life exhibited discernible improvements owing to the implementation of palliative care interventions. Notably, this interdisciplinary approach facilitated the patient's survival for over a year. The present case report strongly advocates for the prompt integration of POM in the surgical management of cancer patients with oral manifestations, which can optimize both the quality of life and overall survival.
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Affiliation(s)
- Murahashi Makoto
- Department of Oral and Maxillofacial Surgery, Urasoe General Hospital, Urasoe, Okinawa 901-2132, Japan
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Nakagami, Nishihara, Okinawa 903-0215, Japan
| | - Edward Hosea Ntege
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Nakagami, Nishihara, Okinawa 903-0215, Japan
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of the Ryukyus, Nakagami, Nishihara, Okinawa 903-0215, Japan
| | - Nishihara Kazuhide
- Department of Oral and Maxillofacial Surgery, Okinawa Red Cross Hospital, Naha, Okinawa 902-8588, Japan
| | - Ide Kentaro
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Nakagami, Nishihara, Okinawa 903-0215, Japan
| | - Shirakawa Jumpei
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Nakagami, Nishihara, Okinawa 903-0215, Japan
| | - Maruyama Nobuyuki
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Nakagami, Nishihara, Okinawa 903-0215, Japan
| | - Kawano Toshihiro
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Nakagami, Nishihara, Okinawa 903-0215, Japan
| | - Shimizu Yusuke
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of the Ryukyus, Nakagami, Nishihara, Okinawa 903-0215, Japan
| | - Nakamura Hiroyuki
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Nakagami, Nishihara, Okinawa 903-0215, Japan
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10
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Sittitrai P, Ruenmarkkaew D, Lekawanvijit S. Esophageal squamous cell carcinoma metastasizing to the oral cavity: a case report and literature review. Ann Med Surg (Lond) 2023; 85:4603-4607. [PMID: 37663702 PMCID: PMC10473335 DOI: 10.1097/ms9.0000000000001086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/09/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction and Importance Metastatic esophageal carcinoma to the oral cavity has been rarely reported, and most cases were adenocarcinoma metastasizing to the mandible. This first report of a case of metastatic esophageal squamous cell carcinoma to the floor of the mouth is crucial due to its rarity and difficulties in diagnosing and managing this condition. Case Presentation A 53-year-old male had a painful submucosal mass on the left side of the floor of the mouth for 2 months. A biopsy indicated a moderately differentiated squamous cell carcinoma. Six months before the intraoral mass appeared, the patient had a moderately differentiated squamous cell carcinoma of the thoracic esophagus and was treated with concurrent chemoradiotherapy. With the previous history and pathological review, the diagnosis of metastatic esophageal squamous cell carcinoma to the floor of the mouth was made. Panendoscopy and an 18F-fluorodeoxyglucose positron emission tomography-computed tomography scan revealed no other abnormality or other distant metastasis. The patient underwent surgical resection with postoperative chemoradiotherapy. He was able to take a regular diet and had good speech function. Ten months after treatment completion, he has had recurrent disease at the floor of the mouth with lung metastasis. Conclusions Oral metastasis from esophageal squamous cell carcinoma is very rare and should be differentiated from primary oral cancer using clinical and pathological features. 18F-fluorodeoxyglucose positron emission tomography-computed tomography scanning is the preferred imaging method to exclude primary tumor persistence and other metastases. Treatment is usually palliative; however, function-preserving surgery may be an option for a patient with limited disease in the oral cavity.
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Affiliation(s)
| | | | - Suree Lekawanvijit
- Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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11
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Yfanti Z, Tetradis S, Nikitakis NG, Alexiou KE, Makris N, Angelopoulos C, Tsiklakis K. Radiologic findings of osteonecrosis, osteoradionecrosis, osteomyelitis and jaw metastatic disease with cone beam CT. Eur J Radiol 2023; 165:110916. [PMID: 37300936 DOI: 10.1016/j.ejrad.2023.110916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 05/17/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023]
Abstract
PURPOSE The purpose of this study was to assess CBCT scans of patients with medication related osteonecrosis of the jaws (MRONJ), osteoradionecrosis (ORN), osteomyelitis (OM) and jaw metastatic disease (JM), evaluate the presence and extent of radiologic findings, identify radiologic parameters that may distinguish the four entities and last, introduce a new modified radiographic index (CRIm), in order to contribute to the diagnosis of these conditions. METHODS Τwo major databases were retrospectively searched for fully documented and diagnosed CBCT scans of MRONJ, ORN, OM and JM from 2006 to 2019. 335 CBCT scans met the inclusion criteria and were assessed under standardized viewing conditions blindly by 2 observers. The CRIm index proposed in this study evaluates: lytic changes, sclerosis, periosteal bone formation, sequestration, non-healing extraction sockets and other findings which included: sinus implication, inferior alveolar canal implication and jaw fracture. Lytic changes, sclerosis, periosteal bone formation, sequestration and non-healing extraction sockets were scored as: absent (0), localized/single (1) and extensive/multiple (2). Each one of other findings were scored individually as: absent (0) and present (1). For statistical analysis t-test, Pearson's r correlation coefficient, one-way ANOVA and Bonferonni were performed. RESULTS Extensive lytic changes were the most common finding, especially for ORN, where it occurred in all CBCT scans (100%). The mean value of the CRIm index differs significantly between CBCT scans with MRONJ and JM, as well as between those with OM and JM (Bonferroni p < 0.001). CONCLUSIONS The new modified Composite Radiographic Index introduced in this study, appears to have improved an objective approach to the previously used Composite Radiographic Index by means of cumulative radiologic features. Τhe predominance of certain radiologic features in one or more of these entities may lead the diagnostician towards the correct diagnosis.
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Affiliation(s)
- Zafeiroula Yfanti
- Department of Oral Diagnosis and Radiology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
| | - Sotirios Tetradis
- Section of Oral Maxillofacial Radiology, UCLA School of Dentistry, Los Angeles, CA, USA.
| | - Nikolaos G Nikitakis
- Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
| | - Konstantina Eleni Alexiou
- Department of Oral Diagnosis and Radiology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
| | - Nikolaos Makris
- Department of Oral Diagnosis and Radiology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
| | - Christos Angelopoulos
- Department of Oral Diagnosis and Radiology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
| | - Kostas Tsiklakis
- Department of Oral Diagnosis and Radiology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
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Marelli S, Ghizzoni M, Pellegrini M, Scribante A, D'Ambrosio G, Sfondrini D. Lung Cancer Cells Infiltration into a Mandibular Follicular Cyst. Case Rep Dent 2023; 2023:7297821. [PMID: 37492277 PMCID: PMC10365922 DOI: 10.1155/2023/7297821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/25/2023] [Accepted: 07/04/2023] [Indexed: 07/27/2023] Open
Abstract
Introduction The oral cavity is a rare site for other organs' tumor metastases. The incidence rate ranges from 1% to 3% of all oral malignancies. Metastases more frequently localize in the mandible, especially in the molar area. Metastases within odontogenic cysts are extremely rare, thus in the literature, only a few cases have been reported. The follicular cyst is one of the most frequent cysts of the jaws. Radiologically it shows as a unilocular lesion with a sclerotic border, characterized by a homogenous radiolucency that incorporates the crown of the unerupted tooth. Methods A 76-year-old female patient, affected by stage IV of lung adenocarcinoma, reported pain on the left mandible border, alongside lip dysesthesia. The ortho-panoramic radiograph showed a follicular cyst in the posterior left side of the mandible, with involvement of the ascending branch region. The cyst was surgically removed together with the impacted tooth. A histopathological examination of the specimen confirmed the diagnostic suspect of a follicular cyst, but in the cystic wall, focal infiltration of epithelial neoplastic cells was also found. The immunohistochemical analysis showed the presence of three different markers: CK 7+, TTF1+/-, and P40-. These markers identify the cells as metastatic lung carcinoma. Results Secondary tumor spreading in the jaws' area is rare (3% of all malignant lesions). Despite odontogenic cysts can undergo a dysplastic transformation (affecting the epithelial covering in ≤1% of the cases), infrequently these neoplastic cells can be related to secondary tumor spreading in a cystic wall. This report describes a metastatic localization within a mandibular follicular cyst. Conclusions Malignant cancers' metastasis in the oral district remains a rare and unexplored condition, especially when metastases are located in odontogenic cysts. In this circumstance, surgical removal and histopathological examination are strongly recommended.
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Affiliation(s)
- Stefano Marelli
- Maxillo-Facial Surgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia 27100, Italy
| | - Martina Ghizzoni
- Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia 27100, Italy
| | - Matteo Pellegrini
- Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan 20122, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, Milan 20122, Italy
| | - Andrea Scribante
- Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia 27100, Italy
| | - Gioacchino D'Ambrosio
- Department of Molecular Medicine, Anatomic Pathology Unit, University of Pavia and Fondazione IRCCS San Matteo Hospital, Pavia 27100, Italy
| | - Domenico Sfondrini
- Maxillo-Facial Surgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia 27100, Italy
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Louredo BVR, De Oliveira MCQ, Brandão TB, Miyahara-Felipe L, Vargas PA, Prado-Ribeiro AC. The first case report of metastatic rectal adenocarcinoma to the oral vestibule in a young woman. Oral Oncol 2023; 143:106441. [PMID: 37302167 DOI: 10.1016/j.oraloncology.2023.106441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 05/30/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND The available literature regarding metastasis to the oral cavity from colorectal cancer, especially rectal cancer, is currently limited. With this in mind, we aimed to report the first case of rectal adenocarcinoma metastasis to the oral vestibule. CASE REPORT A 36-year-old Caucasian female with a 17-months history of rectal adenocarcinoma and several metastases was referred to the Dental Oncology Service due to a nodular swelling in the oral cavity. Intraoral examination showed a large, painless nodule with superficial necrosis on the right side of the mandibular vestibule. An incisional biopsy was performed, and the microscopic analysis demonstrated an infiltrative tumor characterized by islands of malignant epithelial cells with a columnar appearance and tubular pattern. The epithelial component presented pseudoductal structures resemble intestinal mucosa, which exhibited intraluminal secretion. The neoplastic cells were immunoreactive for CDX2 and Cytokeratin 20, and negative for Cytokeratin 7. Therefore, the final diagnosis of metastatic rectal adenocarcinoma was established. Unfortunately, the patient died 23 months after the diagnosis of the primary tumor. CONCLUSION The study highlights that metastases to the oral cavity should be considered in the differential diagnosis of large reactive lesions affecting young patients, especially in the setting of a patient history of cancer.
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Affiliation(s)
- Brendo Vinícius Rodrigues Louredo
- Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Maria Cecília Querido De Oliveira
- Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, Fundação da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
| | - Thaís Bianca Brandão
- Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, Fundação da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
| | - Leika Miyahara-Felipe
- Department of Pathology, Instituto do Câncer do Estado de São Paulo, Fundação da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
| | - Pablo Agustin Vargas
- Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Ana Carolina Prado-Ribeiro
- Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil; Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, Fundação da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
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14
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de Almeida Lança ML, Carvalho YR, Almeida JD, Kaminagakura E. Hidden colon adenocarcinoma diagnosed from mouth metastasis: case report and literature review. World J Surg Oncol 2023; 21:88. [PMID: 36899349 PMCID: PMC9999513 DOI: 10.1186/s12957-023-02978-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/27/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND We report an unusual case of metastatic colon adenocarcinoma to the maxilla as an initial clinical sign of the disease, this being the second case reported in the palate. In addition, we show an extensive review of the literature, with clinical cases of adenocarcinoma with metastasis to the mouth. CASE PRESENTATION An 80-year-old man complained of "swelling on the palate" with a 3-week evolution time. He reported suffering from constipation and high blood pressure. The intraoral examination revealed a pedunculated, red, and painless nodule on the maxillary gingiva. Under the diagnostic hypotheses of squamous cell carcinoma and malignant neoplasm of the salivary gland, an incisional biopsy was performed. Microscopically, the columnar epithelium was observed forming papillary areas, neoplastic cells with prominent nucleoli, hyperchromatic nuclei, atypical mitotic figures, and mucous cells, being positive for CK 20, suggesting the provisional diagnosis of metastatic adenocarcinoma, probably of gastrointestinal origin. The patient was submitted to endoscopy and colonoscopy exams, and a lesion in the sigmoid region of the colon was observed. After a colon biopsy, a moderately differentiated adenocarcinoma was confirmed, establishing the final diagnosis of metastatic neoplasia of colon adenocarcinoma to the oral lesion. The literature review revealed 45 clinical cases of colon adenocarcinoma with metastasis to the oral cavity. To the best of our knowledge, it is the second case on the palate. CONCLUSIONS Colon adenocarcinoma with metastasis to the oral cavity is rare but should be included in the differential diagnosis of neoplasms of the oral cavity, even when there are no known primary tumors in some cases, and this may be the first indication of the presence of a tumor.
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Affiliation(s)
- Maria Leticia de Almeida Lança
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), Avenue: Engenheiro Francisco José Longo, 777, São José dos Campos, 1245-000, Brazil
| | - Yasmin Rodarte Carvalho
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), Avenue: Engenheiro Francisco José Longo, 777, São José dos Campos, 1245-000, Brazil
| | - Janete Dias Almeida
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), Avenue: Engenheiro Francisco José Longo, 777, São José dos Campos, 1245-000, Brazil
| | - Estela Kaminagakura
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), Avenue: Engenheiro Francisco José Longo, 777, São José dos Campos, 1245-000, Brazil.
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Metastatic Lung Cancer to the Head and Neck: A Clinico-Pathological Study on 21 Cases with Narrative Review of the Literature. J Clin Med 2023; 12:jcm12041429. [PMID: 36835963 PMCID: PMC9965358 DOI: 10.3390/jcm12041429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 02/15/2023] Open
Abstract
Metastases from lung cancer to the oral cavity and to the head and neck generally are very infrequent and usually manifest in advanced stages of the disease. Even more rarely, they are the first sign of an unknown metastatic disease. Nevertheless, their occurrence always represents a challenging situation both for clinicians, in the management of very unusual lesions, and for pathologists, in the recognition of the primary site. We retrospectively studied 21 cases of metastases to the head and neck from lung cancer (sixteen males and five females, age range 43-80 years; eight cases localized to the gingiva [two of these to the peri-implant gingiva], seven to the sub-mandibular lymph nodes, two to the mandible, three to the tongue, one case to the parotid gland; in eight patients, metastasis was the first clinical manifestation of an occult lung cancer) and proposed a wide immunohistochemical panel for a proper identification of the primary tumor histotype, including CK5/6, CK8/18, CK7, CK20, p40, p63, TTF-1, CDX2, Chromogranin A, Synaptophysin, GATA-3, Estrogen Receptors, PAX8, PSA. Furthermore, we collected data from previously published studies and narratively reviewed the relevant literature.
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16
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Metastasis of malignant tumors to the oral cavity: Systematic review of case reports and case series. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101330. [PMID: 36371023 DOI: 10.1016/j.jormas.2022.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/06/2022] [Accepted: 11/07/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To summarize published information regarding malignant tumors with metastasis to the oral cavity. MATERIALS AND METHODS This was a systematic review with meta-analysis. An electronic search of Pubmed, Scopus, and Google Scholar databases from inceptions to February 2022 were performed. Only case reports or case series with histopathological results demonstrating metastasis to the oral cavity were included. The main outcomes included demographics, primary site, metastatic site, clinical manifestations, and patient survival. The quality of primary articles was assessed using the Joanna Briggs Institute - University of Adelaide scorecards for case reports and case series. Descriptive analysis and a Kaplan-Meier survival curve were performed. RESULTS 273 articles were selected (50 case series and 223 case reports), for a total of 950 cases. The mean age was 57.11 years. Males were more affected (57.5%). The most common primary sites in women and men was breast (29.8%), and lung (24.8%), respectively. In ∼1/3 of the cases, oral metastasis preceded tumor dissemination. Jawbones were more affected (56.7%) than soft tissues (37.9%), with the mandible being the most affected site (45.5%), followed by the gingiva (19.9%). The most common clinical manifestation was a mass or nodule. Most radiographic evidence was radiolucency of the jaw (60.6%). 3-year and 5-year survival rates were 14.2 and 10.7%. In the majority of cases, the primary tumor was the first to be diagnosed, while in 30.4%, metastasis was the first sign of the disseminated disease. This can be implied that the oral metastasis should be included in the differential diagnosis list of the oral diseases. CONCLUSION Clinicians should be aware of the possibility of, albeit uncommon, oral metastases. Because the extracted data in this review was relatively generalized, the investigators cannot develop the diagnostic clues of oral metastasis, which require further investigations.
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17
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Imajo I, Yamada T, Fujinaga T, Nagano K, Kumamaru W, Yanai Y, Chikui T, Kiyoshima T. Mandibular metastasis from prostate cancer that clinically mimicked osteosarcoma: a case report. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2023. [DOI: 10.1016/j.ajoms.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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18
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Martins FMC, Neto TH, Martins SP, Mendes RB. Metastasis to the oral cavity and jaw bones - A literature review about a case. Oral Oncol 2023; 137:106276. [PMID: 36542993 DOI: 10.1016/j.oraloncology.2022.106276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 11/20/2022] [Accepted: 12/04/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Frederico Miguel Cruz Martins
- Centro Hospitalar e Universitário de São João EPE, Serviço de Cirurgia Maxilofacial, Porto, Portugal; Serviço de Cirurgia Maxilofacial, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal.
| | - Tiago Henriques Neto
- Centro Hospitalar e Universitário de São João EPE, Serviço de Cirurgia Maxilofacial, Porto, Portugal
| | - Sara Pereira Martins
- Centro Hospitalar e Universitário de São João EPE, Serviço de Cirurgia Maxilofacial, Porto, Portugal
| | - Rui Balhau Mendes
- Centro Hospitalar e Universitário de São João EPE, Serviço de Cirurgia Maxilofacial, Porto, Portugal; Hospital de Braga, Braga, Portugal
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19
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Liu X, Liu Y, Sun J, Li N, Fan C, Chen L. Case report: Condylar metastasis from hepatocellular carcinoma: An uncommon case report and literature review. Front Oncol 2023; 12:1085543. [PMID: 36713587 PMCID: PMC9875374 DOI: 10.3389/fonc.2022.1085543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/15/2022] [Indexed: 01/13/2023] Open
Abstract
Background Patients with hepatocellular carcinoma are often affected by metastases, but condylar metastasis is particularly rare. Case presentation A 51-year-old man with a history of hepatocellular carcinoma requested treatment for facial pain. Computed tomography indicated that the condylar bone has been destroyed and fractured. Pathology confirmed condylar metastasis from hepatocellular carcinoma. Complete metastasectomy and condylar reconstruction were performed to preserve his facial appearance. No local recurrence or distant metastasis was found at 8 months of follow-up. Conclusion The condyle can be a metastatic site of hepatocellular carcinoma, regardless of its rarity. Long-term comprehensive surveillance and follow-up are needed for patients with hepatocellular carcinoma. The presence of solitary mass does exclude the possibility of metastatic cancer for these patients, and postoperative imaging and pathological diagnosis are important to determine its origin. If patients' physical condition permits, the mass can be completely excised, and the physiological function can be restored and reconstructed.
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Affiliation(s)
- Xiaojie Liu
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China,School of Stomatology of Qingdao University, Qingdao, Shandong, China
| | - Yanshan Liu
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China,School of Stomatology of Qingdao University, Qingdao, Shandong, China
| | - Jian Sun
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China,School of Stomatology of Qingdao University, Qingdao, Shandong, China
| | - Ningyi Li
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China,School of Stomatology of Qingdao University, Qingdao, Shandong, China
| | - Cunhui Fan
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China,School of Stomatology of Qingdao University, Qingdao, Shandong, China,*Correspondence: Cunhui Fan, ; Liqiang Chen,
| | - Liqiang Chen
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China,School of Stomatology of Qingdao University, Qingdao, Shandong, China,*Correspondence: Cunhui Fan, ; Liqiang Chen,
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20
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Lyon PRP, Trevathan S, Talukdar R, Nguyen DD, McPhaul CM, Rampisela D. A Rare Case of Metastatic Hepatocellular Carcinoma to the Hard Palate. J Investig Med High Impact Case Rep 2022; 10:23247096221133989. [PMID: 36300426 PMCID: PMC9619851 DOI: 10.1177/23247096221133989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Extrahepatic metastasis of hepatocellular carcinoma (HCC) to the head and neck is
unusual, especially the oral cavity/maxillofacial region. Metastatic HCC to the
hard palate, however, is particularly rare. The most common site of HCC
metastasis is the lung, followed by lymph nodes, bone, and adrenal gland.
Importantly, oral cavity metastatic HCC may be misdiagnosed as a primary
malignancy, such as a salivary gland carcinoma. In this article, we describe a
young woman with metastatic HCC to the hard palate that was initially diagnosed
as an acinic cell carcinoma.
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Affiliation(s)
| | | | | | | | | | - Debby Rampisela
- Baylor Scott & White Health,
Temple, TX, USA,Debby Rampisela, MD, Department of
Pathology and Laboratory Medicine, Baylor Scott & White Health, MS-01-266,
2401 S. 31st Street, Temple, TX 76508, USA.
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21
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Nor F, Cuellar JPC, Wongpattaraworakul W, Steward-Tharp S, Austin B, Hellstein J, Lanzel E. An incidental radiolucent lesion involving the angle of the mandible. Oral Surg Oral Med Oral Pathol Oral Radiol 2022:S2212-4403(22)01179-8. [DOI: 10.1016/j.oooo.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/12/2022] [Accepted: 10/10/2022] [Indexed: 11/07/2022]
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Metastatic Carcinoma of the Breast Presenting as Gingival Swelling in the Maxilla: A Case Report. Case Rep Dent 2022; 2022:2667415. [PMID: 36249079 PMCID: PMC9553713 DOI: 10.1155/2022/2667415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 08/20/2022] [Accepted: 08/23/2022] [Indexed: 11/18/2022] Open
Abstract
Background. Metastatic cancers in the oral cavity are usually very rare and are usually an indication of widespread malignancy. In some cases, oral metastasis was found to be the first presentation of distant site tumours. Even though oral metastatic lesions may be found anywhere in the oral cavity, they commonly present in the posterior areas of the jaw bones. Among the soft tissues, the gingiva is the most common site. The presence of inflammation in the gingiva and the role of periodontal microbiota are suggested to play a role in the attraction of metastatic cells. The purpose of this case report is to present a rare case of metastatic breast carcinoma presenting as a gingival enlargement in the maxillary anterior region. Case Presentation. A 37-year-old female patient who underwent modified radical mastectomy for invasive ductal breast carcinoma reported to the dental clinic with a gingival enlargement in the anterior maxillary region. Clinical and radiographic examination showed a rapidly enlarging gingival lesion with destruction of the underlying bone. A wide excision of the entire lesion was done. Histopathological and immunohistochemical (IHC) evaluations were suggestive of infiltrating poorly differentiated adenocarcinoma. Conclusion. This case report presents a metastatic oral lesion in the maxillary anterior region of the primary breast cancer site. The young age of patient and an uncommon site of metastatic lesion are the striking features of this case. We would like to highlight the importance of a thorough clinical, radiological, and histological evaluation of any gingival swelling as it could be a metastatic lesion. IHC staining helps in the diagnosis of the primary site of metastatic carcinomas. An early diagnosis and intervention could reduce the morbidity of the lesion and improve the survival rate.
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23
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Oral pain in the cancer patient. Curr Opin Support Palliat Care 2022; 16:174-179. [DOI: 10.1097/spc.0000000000000608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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24
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Nisi M, Izzetti R, Cinquini C, Pucci A, Graziani F, Barone A. Lung cancer metastases to the oral cavity: Report of two cases and review of literature. Oral Oncol 2022; 134:106082. [PMID: 36001939 DOI: 10.1016/j.oraloncology.2022.106082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/04/2022] [Accepted: 08/10/2022] [Indexed: 11/24/2022]
Affiliation(s)
- Marco Nisi
- Department of Surgical Pathology, Medicine, Molecular and Critical Area, University of Pisa, Pisa, Italy, Via Roma 67, 56126 Pisa, Italy.
| | - Rossana Izzetti
- Department of Surgical Pathology, Medicine, Molecular and Critical Area, University of Pisa, Pisa, Italy, Via Roma 67, 56126 Pisa, Italy
| | - Chiara Cinquini
- Department of Surgical Pathology, Medicine, Molecular and Critical Area, University of Pisa, Pisa, Italy, Via Roma 67, 56126 Pisa, Italy
| | - Angela Pucci
- Department of Surgical Pathology, Medicine, Molecular and Critical Area, University of Pisa, Pisa, Italy, Via Roma 67, 56126 Pisa, Italy
| | - Filippo Graziani
- Department of Surgical Pathology, Medicine, Molecular and Critical Area, University of Pisa, Pisa, Italy, Via Roma 67, 56126 Pisa, Italy
| | - Antonio Barone
- Department of Surgical Pathology, Medicine, Molecular and Critical Area, University of Pisa, Pisa, Italy, Via Roma 67, 56126 Pisa, Italy
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25
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Huang Y, Bao Y, Xu D, Liu L. Gingival metastasis from primary hepatocellular carcinoma: a case report. J Int Med Res 2022; 50:3000605221113408. [PMID: 35883281 PMCID: PMC9340352 DOI: 10.1177/03000605221113408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide;
however, cases with metastasis to the oral cavity are extremely rare. Herein, we report a
68-year-old man who was diagnosed with HCC. Ten months after surgical removal of the right
half of his liver, the patient developed gingival metastasis. Unfortunately, the patient
died 4 months after the diagnosis. We discuss treatment options, pathological results, and
disease prognosis. When a mandibular gingival mass is found, metastatic tumors should be
considered in the differential diagnosis. In this regard, the patient’s medical history
and physical examination are valuable indicators for the diagnosis of mandibular gingival
metastasis. This case provides a basis for the clinical diagnosis of metastatic HCC
involving the oral cavity.
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Affiliation(s)
- Yuan Huang
- Department of Gastroenterology, Yanbian University Hospital, Jilin, China
| | - Yanqiu Bao
- Department of Pathology, Yanbian University Hospital, Jilin, China
| | - Dongyuan Xu
- Department of Pathology, Yanbian University Hospital, Jilin, China
| | - Lan Liu
- Department of Pathology, Yanbian University Hospital, Jilin, China
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Oliver C, Mouallem G, Dutot-Philipeau N, Longis J, Piot B, Bertin H. A case report of condyle metastasis and a review of the literature. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:360-363. [PMID: 33965657 DOI: 10.1016/j.jormas.2021.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 04/26/2021] [Accepted: 04/29/2021] [Indexed: 06/12/2023]
Abstract
Metastasis of the oral cavity is a rare condition and should be investigated for a primary tumor in the lungs, breast, kidney and prostate. Involvement of the mandibular condyle frequently mimics TMJ dysfunction with pain, swelling and limitation of mouth opening. We report the case of atypic TMJ dislocation as an inaugural sign of condyle metastasis. We also discuss the diagnostic approach by a brief review of the literature.
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Affiliation(s)
- Charlotte Oliver
- Service de chirurgie maxillo-faciale et stomatologie, CHU de Nantes, 1 place Alexis Ricordeau, 44093 Nantes, France.
| | - Guillaume Mouallem
- Chirurgie maxillo-faciale et stomatologie, Polyclinique du Parc, avenue des Sables, CS 60908, 49300 Cholet, France.
| | - Noémie Dutot-Philipeau
- Chirurgie maxillo-faciale et stomatologie, Santé Atlantique, avenue Claude Bernard, 44800 Saint-Herblain, France.
| | - Julie Longis
- Service de chirurgie maxillo-faciale et stomatologie, CHU de Nantes, 1 place Alexis Ricordeau, 44093 Nantes, France.
| | - Benoit Piot
- Service de chirurgie maxillo-faciale et stomatologie, CHU de Nantes, 1 place Alexis Ricordeau, 44093 Nantes, France.
| | - Hélios Bertin
- Service de chirurgie maxillo-faciale et stomatologie, CHU de Nantes, 1 place Alexis Ricordeau, 44093 Nantes, France; Laboratoire des sarcomes osseux et remodelage des tissus calcifiés (Phy.Os UMR1238), faculté de médecine, 1 rue Gaston Veil, 44000 Nantes, France.
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27
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Shan S, Liu S, Yang ZY, Wang TM, Lin ZT, Feng YL, Pakezhati S, Huang XF, Zhang L, Sun GW. Oral and maxillofacial pain as the first sign of metastasis of an occult primary tumour: A fifteen-year retrospective study. World J Clin Cases 2022; 10:4436-4445. [PMID: 35663053 PMCID: PMC9125288 DOI: 10.12998/wjcc.v10.i14.4436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/05/2022] [Accepted: 03/16/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Metastatic adenocarcinoma of the jaw (MAJ) is a rare disease that accounts for 1%-3% of all oral and maxillofacial malignant tumours. Oral and maxillofacial pain may be the first symptom of metastatic spread of an occult primary tumour. Therefore, early identification of oral and maxillofacial pain by dental professionals is critical.
AIM To explore the clinical and computerized tomography (CT) features of MAJ with oral and maxillofacial pain as the first symptom.
METHODS The medical records of all patients who were treated in our hospital between January 2006 and February 2020, and diagnosed with MAJ with oral and maxillofacial pain as the first symptom, were reviewed retrospectively. Clinical data were collected on age, sex, medical history, clinical manifestations, site of metastasis, and site of the primary lesion. CT features were analysed in detail, and a radiological classification scheme comprising five types: Osteolytic, osteoblastic, mixed, cystic, and alveolar bone resorption was proposed.
RESULTS The primary sites of MAJ were the lungs (n = 6), liver (n = 4), kidneys (n = 2), prostate (n = 1), and gastric cardia (n = 1). Five tumours were classified as the osteolytic type, all with a permeative margin (100%, P < 0.05), and three were classified as the mixed type, mostly with a moth-eaten margin (80%, P < 0.05). The cystic (n = 3) and alveolar bone resorption (n = 1) types had geographic margins, and the osteoblastic type (n = 1) had sclerotic margins. Moreover, nine tumours showed periosteal reaction and five showed a localised soft tissue mass, while the occurrence of jaw expansion was relatively rare.
CONCLUSION MAJ has complex clinical and CT features. Oral and maxillofacial pain may be the first sign of a primary tumour affecting other sites.
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Affiliation(s)
- Shan Shan
- Department of Dentomaxillofacial Radiology, The Affiliated Stomatology Hospital of Medical School, Nanjing University, Nanjing 210008, Jiangsu Province, China
| | - Shu Liu
- Department of Dentomaxillofacial Radiology, The Affiliated Stomatology Hospital of Medical School, Nanjing University, Nanjing 210008, Jiangsu Province, China
| | - Zhen-Yu Yang
- Department of Dentomaxillofacial Radiology, The Affiliated Stomatology Hospital of Medical School, Nanjing University, Nanjing 210008, Jiangsu Province, China
| | - Tie-Mei Wang
- Department of Dentomaxillofacial Radiology, The Affiliated Stomatology Hospital of Medical School, Nanjing University, Nanjing 210008, Jiangsu Province, China
| | - Zi-Tong Lin
- Department of Dentomaxillofacial Radiology, The Affiliated Stomatology Hospital of Medical School, Nanjing University, Nanjing 210008, Jiangsu Province, China
| | - Ying-Lian Feng
- Department of Dentomaxillofacial Radiology, The Affiliated Stomatology Hospital of Medical School, Nanjing University, Nanjing 210008, Jiangsu Province, China
| | - Seyiti Pakezhati
- Department of Dentomaxillofacial Radiology, The Affiliated Stomatology Hospital of Medical School, Nanjing University, Nanjing 210008, Jiangsu Province, China
| | - Xiao-Feng Huang
- Department of Oral Pathology,The Affiliated Stomatology Hospital of Medical School, Nanjing University, Nanjing 210008, Jiangsu Province, China
| | - Lei Zhang
- Department of Oral Pathology,The Affiliated Stomatology Hospital of Medical School, Nanjing University, Nanjing 210008, Jiangsu Province, China
| | - Guo-Wen Sun
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Medical School, Nanjing University, Nanjing 210008, Jiangsu Province, China
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Metastatic Tumors to the Oral Soft Tissues and Jawbones: A Retrospective Analysis of 40 Cases and Review of the Literature. Head Neck Pathol 2022; 16:802-813. [PMID: 35438419 PMCID: PMC9424411 DOI: 10.1007/s12105-022-01451-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/27/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Metastasis to the oral soft tissues and jawbones is rare and frequently associated with wide spread disease and dismal prognosis. Herein, we report the clinicopathologic characteristics of 40 intraoral metastatic neoplasms and perform a comprehensive review of the pertinent literature. METHODS Criteria for inclusion included: (a) archived cases from the UMN Oral Pathology laboratory with available tissue blocks and/or H&E-stained preparations diagnosed between 2003 and 2021, (b) proper documentation of the clinico-radiographic characteristics of oral metastasis along with confirmed history of primary malignancy, or (c) microscopic findings consistent with metastatic disease with or without discovery of the primary site. RESULTS Intraoral metastases comprised 0.03% of all accessioned cases; 22 (55%) occurred in men and 18 (45%) in women (median age = 66.5; range = 18-94 years). Eighteen cases (45%) involved the gingiva, 16 (40%) the gingiva and jawbones, 5 (12.5%) were exclusively intraosseous, and 1 affected (2.5%) the tongue. The lung was the two most frequent primary site in both men (n = 6, 27.3%) and women (n = 5, 27.7%), followed by the colon (n = 4, 18.2%) and kidney (n = 3, 13.7%) in men, and colon (n = 4, 22.2%) and breast (n = 3, 16.6%) in women. Analysis of 1,084 metastatic cases from the literature (male-to-female ratio = 1.2; mean = 52.3; range = 0.6-90 years) indicated strong preference for the jawbones (69.5%) and significant site-specific predilection of certain primary malignancies. CONCLUSIONS Oral and gnathic metastases are rare but demonstrate a clear predilection for the gingiva and mandible. Clinicians should remain cognizant of such lesions since they frequently mimic inflammatory, reactive or benign neoplastic processes and, in certain cases, are the first indication of occult disease.
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29
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Giovannacci I, Vescovi P, Corcione L, Corradi D, Bologna-Molina R, Meleti M. Mandibular metastasis from carcinoma of the bladder: Report of a case and literature review. J Clin Exp Dent 2022; 14:e376-e379. [PMID: 35419177 PMCID: PMC9000391 DOI: 10.4317/jced.57293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 02/06/2022] [Indexed: 02/07/2023] Open
Abstract
Metastases represent about 1% of all malignant tumors of the oral region. Only 12 cases of metastases to the jawbones and 3 to the oral soft tissues from a carcinoma of the bladder are reported in the English literature. Here we report a case of an 86 year-old man with a metastasis to the anterior region of the lower jaw from a transitional cell carcinoma of the bladder treated 5 years before, all-together with a literature review. Key words:Bladder, mandibular metastasis, oral metastasis, transitional cell carcinoma.
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Affiliation(s)
- Ilaria Giovannacci
- DDS, Msc. Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Paolo Vescovi
- DDS, Msc, PhD. Centro Universitario di Odontoiatria, Department of Medicine and Surgery, Oral Medicine and Laser Surgery Unit, University of Parma, Parma, Italy
| | - Luigi Corcione
- MD. Department of Medicine and Surgery, Section of Human Pathology and Histopathology, University of Parma, Parma, Italy
| | - Domenico Corradi
- MD. Department of Medicine and Surgery, Section of Human Pathology and Histopathology, University of Parma, Parma, Italy
| | - Ronell Bologna-Molina
- DDS, PhD. Molecular Pathology Area, School of Dentistry, Universidad de la República, Uruguay
| | - Marco Meleti
- DDS, PhD. Centro Universitario di Odontoiatria, Department of Medicine and Surgery, Oral Medicine and Laser Surgery Unit, University of Parma, Parma, Italy
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30
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Pawar D, Arif D, Raghunath A, Rehman S. Urothelial carcinoma with mandibular metastasis and synchronous prostate cancer. BMJ Case Rep 2022; 15:e247419. [PMID: 35288430 PMCID: PMC8921866 DOI: 10.1136/bcr-2021-247419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2022] [Indexed: 11/03/2022] Open
Abstract
Only 4% of newly diagnosed bladder cancer (BC) patients present with metastatic disease. The most common reported sites of metastases are lymph nodes, bones, lung, liver and peritoneum. Mandibular metastasis is very rare. We report a case of muscle-invasive urothelial cancer metastasised to the mandible and with an incidental finding of high-risk prostate cancer (PC). Incidental finding of PC in BC patients may be suggestive of a common aetiology. Treatment for BC and PC can be delivered in parallel, including platinum-based chemotherapy, cystectomy and androgen depletion therapy. Prognosis of metastatic BC is poor, and high-risk PC may affect progression-free survival of BC. Our case highlights importance of considering BC metastasis to the jaw as well as synchronous PC in the management of patients presenting with BC.
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Affiliation(s)
- Dushyant Pawar
- Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Dauod Arif
- Pathology, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Arrvind Raghunath
- Hematology Oncology, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Shabnam Rehman
- Hematology Oncology, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
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31
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Bello IO, Pedersen AML, Alghamdi OG, AlSadhan R. Anterior maxillary gingival overgrowth with associated submandibular lymphadenopathy. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:282-288. [PMID: 35221246 DOI: 10.1016/j.oooo.2022.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 12/24/2021] [Accepted: 01/11/2022] [Indexed: 12/26/2022]
Affiliation(s)
- Ibrahim O Bello
- Associate Professor, Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
| | - Anne Marie Lynge Pedersen
- Professor, Section of Oral Medicine and Pathology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Osama G Alghamdi
- Assistant Professor, Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Ra'ed AlSadhan
- Associate Professor, Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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32
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Jaw metastases and the general dental practitioner. Br Dent J 2021; 231:629-633. [PMID: 34824428 DOI: 10.1038/s41415-021-3666-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 04/05/2021] [Indexed: 11/08/2022]
Abstract
Metastatic spread to the oral cavity is a rare entity, comprising 1% of oral malignancies. However, 25% of oral metastases are found to be the initial sign of metastatic spread; therefore, initial presentation in the oral cavity may indicate significant underlying disease. Common primary sites for men include the prostate, lung, kidney and liver. For women, it is the breast, kidney, colon and genital organs. General dental practitioners are in a unique position to identify and instigate rapid referrals as gatekeepers of primary care whereby patients commonly present to them with symptoms. This clinical review article aims to educate dental practitioners on appropriate recognition of oral metastatic pathology and referral to secondary care.
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33
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Araújo ALD, Fonsêca JM, do Amaral-Silva GK, de Lima Morais TM, Mariz BALA, Fonseca FP, Lopes MA, Vargas PA, Santos-Silva AR, de Almeida OP. The Role of Immunohistochemistry for Primary Oral Diagnosis in a Brazilian Oral Pathology Service. Appl Immunohistochem Mol Morphol 2021; 29:781-790. [PMID: 34320560 DOI: 10.1097/pai.0000000000000960] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 06/03/2021] [Indexed: 10/20/2022]
Abstract
A proper antibody panel selection is one of the most important factors to reach an adequate diagnosis in challenging cases. This retrospective study was designed to determine the contribution of immunohistochemistry (IHC) in the primary diagnosis of oral diseases in one of the main services of oral pathology in the State of São Paulo, Brazil, and to identify the most common antibodies used, and recommend diagnostic algorithms based on our experience with challenging lesions. A total of 1698 IHC stains were performed in 401 cases from a total of 28,804 cases received from public dental clinics and private dental practitioners within a period of 13 years, representing a frequency of 1.4% of IHC solicitations. Among these, 112 (28%) were mandatory to reach a final diagnosis and 255 (63.6%) were confirmative. In 34 (8.4%) cases, it was not possible to reach a conclusive/final diagnosis, even with IHC. Regarding the nature of the lesions, 210 (52.3%) were benign, 163 (40.6%) were malignant tumors, 13 (3.2%) were reactive, 10 (2.5%) were premalignant, and 5 (1.2%) were lesions of uncertain malignancy. Small amount of tissue of some incisional biopsies, overlapping features of spindle cell lesions (epithelial, neural, melanocytic, smooth muscle, endothelial, and fibroblastic/myofibroblastic cell differentiation), and overlapping features of salivary gland lesions were the most frequent challenges in which IHC stains were requested. Spindle cell lesions were the most frequent (22%) among all cases that required IHC to reach a final diagnosis. The implementation of IHC for routine practice requires a wide range of markers, proper antibody selection, and knowledge to interpret the subjectivity of staining. The inherent limitation of incisional biopsies was pointed as a reason to inconclusive diagnosis, despite a wide range of antibodies that our laboratory displays.
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Affiliation(s)
- Anna Luíza D Araújo
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo
| | - Jéssica M Fonsêca
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo
| | | | - Thayná M de Lima Morais
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo
| | - Bruno A L A Mariz
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo
| | - Felipe P Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Marcio A Lopes
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo
| | - Pablo A Vargas
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo
| | - Alan R Santos-Silva
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo
| | - Oslei P de Almeida
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo
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34
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Yaminian JB, Peters SM. Ulcerated gingival mass in a 45-year-old woman. J Am Dent Assoc 2021; 153:1006-1009. [PMID: 34656293 DOI: 10.1016/j.adaj.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/09/2021] [Accepted: 07/08/2021] [Indexed: 11/17/2022]
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35
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Metastasis of pulmonary adenocarcinoma to the buccal mucosa and submandibular area. J Dent Sci 2021; 16:1315-1316. [PMID: 34484606 PMCID: PMC8403790 DOI: 10.1016/j.jds.2021.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 02/15/2021] [Indexed: 11/23/2022] Open
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36
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Kumar Upadhyay A, Prakash A, Rana F, Jain N. A Rare Case of Chondrosarcoma With Metastasis to the Oral Cavity. Cureus 2021; 13:e16283. [PMID: 34373826 PMCID: PMC8346260 DOI: 10.7759/cureus.16283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2021] [Indexed: 11/05/2022] Open
Abstract
Chondrosarcomas with metastases to oral cavities are extremely rare. To the best of our knowledge, only six cases of chondrosarcoma with metastases to the oral cavity, maxilla, and/or mandible have been reported in the English-language literature. The last such case was reported three decades earlier; none of the reported cases were from India. We present the case of an Indian patient with chondrosarcoma in the knee region, who was treated with surgical excision in 2013. However, he experienced a recurrence in 2019, developed upper gingival metastasis in 2020, and succumbed within two months of this unique presentation. Oral metastatic lesions have a wide differential diagnosis, and awareness of this rare presentation can help clinicians maintain an index of suspicion for an underlying metastatic malignancy. Our experience emphasizes the importance of detailed history-taking, clinical examination, and consideration of metastases as a differential diagnosis, even if there is no reported history of malignancy. Such lesions may also be the first sign of an occult primary tumor, which will require prompt investigation for early diagnosis and treatment.
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Affiliation(s)
| | | | - Farah Rana
- Pathology, Tata Main Hospital, Jamshedpur, IND
| | - Neeraj Jain
- Medical Oncology, Tata Main Hospital, Jamshedpur, IND
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37
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Gandolfo MS, Denninghoff V, Avagnina A, Adler LI. Diagnosis of an adenocarcinoma of Müllerian origin made as a result of its metastasis in the mouth floor. BMJ Case Rep 2021; 14:14/6/e240944. [PMID: 34187793 DOI: 10.1136/bcr-2020-240944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Metastases derived from primary tumours distant to the oral and maxillofacial region account for only 1% of all malignancies at that location, usually with a poor prognosis. In women, the primary tumours that most frequently metastasise to the oral cavity are breast adenocarcinomas affecting the jawbones and soft tissues (41% and 24%, respectively), followed by adrenal glands and female genital organs to the jawbones (8%), and female genital organs to the soft tissues (15%). Metastatic tumours of the mouth are a challenging diagnosis because of their exceptional occurrence. We report on the case of an 83-year-old woman who consulted for a bleeding ulcerated tumour on the floor of the mouth. A biopsy-confirmed metastasis of an adenocarcinoma of Müllerian origin. The oral lesion was the first sign of undetected cancer. The patient agreed to surgical resection and was further referred to palliative care for her symptoms.
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Affiliation(s)
- Mariana Silva Gandolfo
- Faculty of Dentistry, University of Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Valeria Denninghoff
- Faculty of Dentistry, University of Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.,CONICET, Ciudad Autónoma de Buenos Aires, Argentina
| | | | - Lidia Isabel Adler
- Faculty of Dentistry, University of Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
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38
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Holmes KR, Holmes RD, Martin M, Murray N. Practical Approach to Radiopaque Jaw Lesions. Radiographics 2021; 41:1164-1185. [PMID: 34086497 DOI: 10.1148/rg.2021200187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Radiopaque lesions of the jaw are myriad in type and occasionally protean in appearance. In turn, the radiologic analysis of these lesions requires a systematic approach and a broad consideration of clinical and imaging characteristics to enable reliable radiologic diagnosis. Initially categorizing lesions by attenuation pattern provides a practical framework for organizing radiopaque jaw lesions that also reflects important tissue characteristics. Specifically, the appearance of radiopaque lesions can be described as (a) densely sclerotic, (b) ground glass, or (c) mixed lytic-sclerotic, with each category representing a distinct although occasionally overlapping differential diagnosis. After characterizing attenuation pattern, the appreciation of other radiologic features, such as margin characteristics or relationship to teeth, as well as clinical features including demographics and symptoms, can aid in further narrowing the differential diagnosis and lend confidence to clinical decision making. The authors review the potential causes of a radiopaque jaw lesion, including pertinent clinical and radiologic features, and outline a simplified approach to its radiologic diagnosis, with a focus on cross-sectional CT. An invited commentary by Buch is available online. ©RSNA, 2021.
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Affiliation(s)
- Kenneth R Holmes
- From the Departments of Medicine (K.R.H.) and Radiology (R.D.H.), University of British Columbia, 2775 Laurel St, 11th Floor, Vancouver, BC, Canada V5Z 1M9; BC Cancer Agency, Vancouver, British Columbia, Canada (M.M.); and Vancouver General Hospital, Vancouver, British Columbia, Canada (N.M.)
| | - R Davis Holmes
- From the Departments of Medicine (K.R.H.) and Radiology (R.D.H.), University of British Columbia, 2775 Laurel St, 11th Floor, Vancouver, BC, Canada V5Z 1M9; BC Cancer Agency, Vancouver, British Columbia, Canada (M.M.); and Vancouver General Hospital, Vancouver, British Columbia, Canada (N.M.)
| | - Montgomery Martin
- From the Departments of Medicine (K.R.H.) and Radiology (R.D.H.), University of British Columbia, 2775 Laurel St, 11th Floor, Vancouver, BC, Canada V5Z 1M9; BC Cancer Agency, Vancouver, British Columbia, Canada (M.M.); and Vancouver General Hospital, Vancouver, British Columbia, Canada (N.M.)
| | - Nicolas Murray
- From the Departments of Medicine (K.R.H.) and Radiology (R.D.H.), University of British Columbia, 2775 Laurel St, 11th Floor, Vancouver, BC, Canada V5Z 1M9; BC Cancer Agency, Vancouver, British Columbia, Canada (M.M.); and Vancouver General Hospital, Vancouver, British Columbia, Canada (N.M.)
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39
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Kosanwat T, Poomsawat S, Kitisubkanchana J. Non-endodontic periapical lesions clinically diagnosed as endodontic periapical lesions: A retrospective study over 15 years. J Clin Exp Dent 2021; 13:e586-e593. [PMID: 34188765 PMCID: PMC8223148 DOI: 10.4317/jced.57957] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 01/23/2021] [Indexed: 01/17/2023] Open
Abstract
Background This study aimed to provide the frequency and demographic data of non-endodontic periapical lesions clinically misdiagnosed as endodontic periapical lesions from a Southeast Asian population over a 15-year period.
Material and Methods A retrospective study was conducted from departmental archives between 2005 and 2019. Cases clinically diagnosed as endodontic periapical lesions were retrieved. Then, cases with a histopathological diagnosis of non-endodontic periapical lesion were selected. Demographic data of non-endodontic periapical lesions were recorded. Radiographic features of cases with available radiographs were analyzed.
Results Of 1,566 cases clinically diagnosed as endodontic periapical lesion, 157 cases received a histopathological diagnosis of non-endodontic origin. Eighteen different histopathological diagnoses were identified. The most frequent lesion was dentigerous cyst (n= 51, 32.48%) followed by odontogenic keratocyst (n=31, 19.75%), nasopalatine duct cyst (n=18, 11.46%) and ameloblastoma (n=15, 9.56%). Three cases of malignant tumors, including adenoid cystic carcinoma, mucoepidermoid carcinoma, and metastatic papillary thyroid carcinoma were observed.
Conclusions Non-endodontic periapical lesions constituted 10.03% of cases clinically diagnosed as endodontic periapical lesions. Histopathological examinations of non-endodontic periapical lesions revealed a variety of lesions ranging from foreign body reaction, cysts, fibro-osseous lesions, benign tumors and primary or metastatic malignant tumors. Of clinical significance is that some non-endodontic periapical lesions had different treatment modalities and prognoses compared with endodontic lesions. Therefore, dentists must be aware that periapical radiolucent lesions are not always a consequence of pulpal necrosis. Key words:Ameloblastoma, dentigerous cyst, endodontic periapical lesions, non-endodontic periapical lesions, odontogenic keratocyst.
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Affiliation(s)
- Theerachai Kosanwat
- DDS, Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Sopee Poomsawat
- DDS, MSc, PhD, Associate Professor, Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Jira Kitisubkanchana
- DDS, PhD, Associate Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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40
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Moreira C, Corrales T. Pancreatic adenocarcinoma metastasis to the oral cavity: A rare case report and literature review. Oral Oncol 2021; 116:105157. [PMID: 33454219 DOI: 10.1016/j.oraloncology.2020.105157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 12/15/2020] [Indexed: 11/24/2022]
Abstract
A patient suffering from metastatic pancreatobiliary adenocarcinoma was referred to our hospital's stomatology department after a rapidly progressing swelling in the right mandibular angle, trismus and preauricular pain of 3-month duration. A mandible CT scan showed extensive bone rarefaction and a thickening of the contiguous soft tissues that involved the medial masseter and pterygoid muscle. The morphological findings and immunohistochemical profile were compatible with bone metastasis from pancreatic adenocarcinoma. Therefore, palliative treatment was proposed to the patient. Pancreatic cancer metastases to the oral cavity are extremely rare and characterized by its poor prognosis. Herein we describe the ninth case of metastatic spread to the jaw which is also remarkably the longest surviving reported case up to date.
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Affiliation(s)
- C Moreira
- Stomatology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho E.P.E., Rua Conceição Fernandes S/N, 4434-502 Vila Nova De Gaia, Portugal
| | - T Corrales
- Stomatology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho E.P.E., Rua Conceição Fernandes S/N, 4434-502 Vila Nova De Gaia, Portugal
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Shimono H, Hirai H, Oikawa Y, Mochizuki Y, Kuroshima T, Tomioka H, Kayamori K, Ikeda T, Harada H. Metastatic tumors in the oral region: a retrospective chart review of clinical characteristics and prognosis. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:648-652. [PMID: 34511353 DOI: 10.1016/j.oooo.2021.04.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 04/16/2021] [Accepted: 04/21/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The study aimed to evaluate the clinical characteristics and outcomes of patients with metastatic tumors in the oral region. STUDY DESIGN We conducted a retrospective study of 14 patients (11 men and 3 women; median age, 70.5 years) with metastatic tumors in the oral region diagnosed between 2005 and 2018. RESULTS The primary tumors were located in the lung (n = 7), kidney (n = 3), renal pelvis (n = 1), thyroid (n = 1), stomach (n = 1), and bladder (n = 1). The most common histologic type of the tumor was adenocarcinoma (n = 6). The metastatic sites were the mandible (n = 7), tongue (n = 4), upper gingiva (n = 2), and maxilla (n = 1). In 6 patients, metastatic tumors were found in the oral region before the primary tumors were detected. The primary tumors were detected by positron emission tomography/computed tomography in 5 patients and by computed tomography alone in one patient. Seven patients received treatment for metastatic tumors in the oral region. The overall 1- and 5-year survival rates were 35.7% and 10.7%, respectively. CONCLUSIONS It is important to detect metastatic tumors in the oral region and primary tumors as early as possible. Radical or palliative treatment should be performed if possible, considering the condition of the primary tumor and its metastasis to other organs.
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Affiliation(s)
- Hiroaki Shimono
- Department of Oral and Maxillofacial Surgery, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Hideaki Hirai
- Department of Oral and Maxillofacial Surgery, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yu Oikawa
- Department of Oral and Maxillofacial Surgery, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yumi Mochizuki
- Department of Oral and Maxillofacial Surgery, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeshi Kuroshima
- Department of Oral and Maxillofacial Surgery, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hirofumi Tomioka
- Department of Oral and Maxillofacial Surgery, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kou Kayamori
- Department of Oral Pathology, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tohru Ikeda
- Department of Oral Pathology, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroyuki Harada
- Department of Oral and Maxillofacial Surgery, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Abstract
Sclerotic lesions of the jaw are uncommon but may be clinically relevant. In this pictorial review, the most common sclerotic lesions are discussed. Three categories of lesions are distinguished; odontogenic sclerotic lesions, non-odontogenic sclerotic lesions, and mixed lytic-sclerotic lesions. In each group, non-neoplastic conditions are discussed first, followed by benign and malignant neoplasms. For each disease a brief overview is given, including histological features, epidemiology, symptoms, typical location, imaging features, and treatment. This review emphasizes which basic observations are essential to the evaluation of sclerotic jaw lesions and what elements have to be taken into account to create a proper differential diagnosis.
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43
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Radiological spectrum of metastasis to the oral and maxillofacial region. Oral Radiol 2021; 38:37-48. [PMID: 33743130 DOI: 10.1007/s11282-021-00523-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 02/27/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Oral and maxillofacial metastasis may be the first indication of an undiscovered malignancy in a significant number of cases. Therefore, the rationale of this article is to highlight the clinical and radiological presentation of metastatic lesions involving the oral and maxillofacial region. This will serve as a reference for clinicians, who may first encounter patients with possible metastatic lesions in this region. METHODS Histologically confirmed cases of oral and maxillofacial metastasis were retrospectively reviewed over a 30-year period. Twenty-three patients were included in the study. The following clinical information was reviewed: age at diagnosis, gender, medical history, main complaint, site of metastatic tumour, radiological features, preliminary clinical diagnosis and final histological diagnosis. RESULTS Females were twice as commonly affected, with metastatic lesions three times more likely to occur in the mandible. Common clinical presentations included swelling, pain and paraesthesia, with non-specific dental-related symptoms occurring in a few cases. Fifteen cases presented radiologically with an osteolytic lesion with poorly demarcated margins. Four cases presented with well demarcated lesions with additional signs of destruction. Additionally, four cases showed an osteogenic radiological appearance. In the current population sample, metastasis to the oral and maxillofacial region most commonly originated from the breast. CONCLUSION Lesions with poorly demarcated margins with cortical destruction, accompanied by clinical signs of swelling, pain and paraesthesia in the absence of any inflammatory process, should raise suspicion for metastasis. Considering the poor prognosis of these metastatic lesions, the responsibility lies with the clinician to identify these lesions and make appropriate referrals.
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Oral and Maxillo-Facial Manifestations of Systemic Diseases: An Overview. ACTA ACUST UNITED AC 2021; 57:medicina57030271. [PMID: 33809659 PMCID: PMC8002330 DOI: 10.3390/medicina57030271] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/12/2021] [Accepted: 03/12/2021] [Indexed: 12/12/2022]
Abstract
Many systemic (infective, genetic, autoimmune, neoplastic) diseases may involve the oral cavity and, more generally, the soft and hard tissues of the head and neck as primary or secondary localization. Primary onset in the oral cavity of both pediatric and adult diseases usually represents a true challenge for clinicians; their precocious detection is often difficult and requires a wide knowledge but surely results in the early diagnosis and therapy onset with an overall better prognosis and clinical outcomes. In the current paper, as for the topic of the current Special Issue, the authors present an overview on the most frequent clinical manifestations at the oral and maxillo-facial district of systemic disease.
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Kaur H, Mishra D, Manchanda S, Bhutia O. Mandibular tumour as the primary manifestation of an occult adenocarcinoma. BMJ Case Rep 2021; 14:14/1/e239151. [PMID: 33414122 PMCID: PMC7797288 DOI: 10.1136/bcr-2020-239151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Oral cavity is an uncommon site for occurrence of metastasis and usually indicates widespread systemic disease. Primary tumours from the lung most commonly metastasise to oral soft tissues (31.3%) and jaw bones (22%) among men. It is quite challenging to diagnose a solitary metastatic lesion and to determine the site of primary lesion, due to the rarity of these occurrences. This case report describes the jaw bone as a first sign of occult primary lung adenocarcinoma with multiple metastases in 47-year-old man. The patient was treated with the combination of carboplatin and paclitaxel, and has completed two cycles till date with a stable clinical course. Diagnosis of metastatic carcinoma of jaw is very challenging. The pathologist must have knowledge of ancillary techniques along with clinical, radiological and histological correlation to determine the origin of distant primary.
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Affiliation(s)
- Harpreet Kaur
- Department of Oral Pathology and Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Deepika Mishra
- Department of Oral Pathology and Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Smita Manchanda
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Ongkila Bhutia
- Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
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Li S, Wang W. Extracellular Vesicles in Tumors: A Potential Mediator of Bone Metastasis. Front Cell Dev Biol 2021; 9:639514. [PMID: 33869189 PMCID: PMC8047145 DOI: 10.3389/fcell.2021.639514] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/11/2021] [Indexed: 12/11/2022] Open
Abstract
As one of the most common metastatic sites, bone has a unique microenvironment for the growth and prosperity of metastatic tumor cells. Bone metastasis is a common complication for tumor patients and accounts for 15-20% of systemic metastasis, which is only secondary to lung and liver metastasis. Cancers prone to bone metastasis include lung, breast, and prostate cancer. Extracellular vesicles (EVs) are lipid membrane vesicles released from different cell types. It is clear that EVs are associated with multiple biological phenomena and are crucial for intracellular communication by transporting intracellular substances. Recent studies have implicated EVs in the development of cancer. However, the potential roles of EVs in the pathological exchange of bone cells between tumors and the bone microenvironment remain an emerging area. This review is focused on the role of tumor-derived EVs in bone metastasis and possible regulatory mechanisms.
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Affiliation(s)
- Shenglong Li
- Department of Bone and Soft Tissue Tumor Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
- Department of Tissue Engineering, Center of 3D Printing & Organ Manufacturing, School of Fundamental Sciences, China Medical University, Shenyang, China
- *Correspondence: Shenglong Li,
| | - Wei Wang
- Department of Bone and Soft Tissue Tumor Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
- Wei Wang,
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Bugshan AS, Alsaati MA, Syed FA, Almulhim KS, Abdulhady AI. Incidental Diagnosis on Orthopantomography of Langerhans Cell Histiocytosis with Multifocal Jaw Involvement: A Case Report of Single-System Disease. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e928307. [PMID: 33232308 PMCID: PMC7701021 DOI: 10.12659/ajcr.928307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Langerhans cell histiocytosis (LCH) is a relatively rare neoplasm with a strong inflammatory component. It has diverse clinical manifestations, which range from a single lesion or multiple bony lesions to severe multisystem involvement. Approximately 10% to 20% of cases of LCH occur in the jaw, with the posterior mandible being the site most frequently involved. CASE REPORT We report on the case of a 42-year-old man who presented with bilateral osteolytic lesions in the posterior mandible that were incidentally discovered during routine radiographic screening. Histological examination of the specimen confirmed the diagnosis of LCH. CONCLUSIONS This case illustrates the importance of orthopantomography (OPG) as a screening tool in new patients to perform an overall evaluation of the teeth and surrounding structures, such as the bone, temporomandibular joint, and sinuses. Moreover, OPG can be used to screen for the presence of asymptomatic lesions that are often diagnosed incidentally on radiographs.
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Affiliation(s)
- Amr S Bugshan
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammed A Alsaati
- Department of Maxillofacial and Oral Health, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Faiyaz A Syed
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Khalid S Almulhim
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Adel I Abdulhady
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Rocha BA, Paranaíba LMR, Dantas CD, de Carvalho MGF, de Melo-Filho MR, Lima LMC, Souto GR, Horta MCR. Two rare cases of oral metastasis arising from lung adenocarcinoma and esophageal carcinoma. J Clin Exp Dent 2020; 12:e999-e1004. [PMID: 33154803 PMCID: PMC7600200 DOI: 10.4317/jced.57125] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/02/2020] [Indexed: 12/25/2022] Open
Abstract
Metastasis to the oral cavity are rare, representing only 1% of all oral malignancies, and originate from various sites such as the breast, prostate, lung and kidney. Clinically, they can simulate reactive and inflammatory lesions common in the oral cavity, and the clinical and microscopic diagnosis of these metastasis is a challenge. In this article, we report two new cases of esophageal and lung metastasis to oral tissues, highlighting their clinical characteristics and the process of diagnostic elucidation. We emphasize the importance for clinicians to consider the possibility of metastatic lesions in the oral cavity in patients previously diagnosed with malignant lesions in distant tissues and organs. Key words:Diagnosis, esophageal squamous cell carcinoma, adenocarcinoma of lung, oral cavity, metastasis.
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Affiliation(s)
- Breno-Amaral Rocha
- Graduate Program in Dentistry, School of Dentistry, Pontifícia Universidade Católica de Minas Gerais (PUC Minas), Belo Horizonte, Minas Gerais, Brazil
| | - Lívia-Maris-Ribeiro Paranaíba
- Department of Pathology and Parasitology, Institute of Biomedical Sciences, Federal University of Alfenas, Alfenas, MG, Brazil
| | - Ciro-Dantas Dantas
- Department of Oral Diagnosis, School of Dentistry, State University of Campinas, Sao Paulo, Brazil
| | | | | | | | - Giovanna-Ribeiro Souto
- Graduate Program in Dentistry, School of Dentistry, Pontifícia Universidade Católica de Minas Gerais (PUC Minas), Belo Horizonte, Minas Gerais, Brazil
| | - Martinho-Campolina-Rebello Horta
- Graduate Program in Dentistry, School of Dentistry, Pontifícia Universidade Católica de Minas Gerais (PUC Minas), Belo Horizonte, Minas Gerais, Brazil
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Malignant Lesions Mimicking Endodontic Pathoses Lesion: A Systematic Review. J Endod 2020; 47:178-188. [PMID: 32918962 DOI: 10.1016/j.joen.2020.08.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/14/2020] [Accepted: 08/31/2020] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Malignant nonendodontic periapical lesions represent a rare diagnosis, in which few case have been reported about this condition. Due to the low occurrence and little exploration of this subject, serious errors of diagnosis are observed in the oral medicine services. In this sense, the purpose of the present review was to integrate the information on the record published on malignant lesions that mimic endodontic pathoses into a comprehensive analysis of their clinical, radiologic, and histopathologic features. METHODS An online search was made in March 2020 in the following databases: Pubmed, Web of Science, and Scopus. Eligibility criteria included publications having enough clinical, radiologic, and histopathologic information to confirm the diagnosis. Data were assessed descriptively. RESULTS Forty-nine publications from 16 countries comprising 60 cases were included. There is a nearly equal occurrence rate between males and females (male/female ratio is 49.15%/50.84%) with a mean age of 46.56 years. The lesions were more prevalent in the posterior mandibles (40.69%), and, radiographically, they were unilocular radiolucent. Histopathologic analysis showed metastasis (26.67%) as the most prevalent lesion followed by salivary gland malignant disease (25%). CONCLUSIONS The present systematic review revealed several histologic types of malignant periapical lesions that could be mimicking endodontic pathoses. Because these lesions usually do not show clinical or radiologic features of malignant alteration, clinicians should consider these hypotheses in their routine.
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50
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Kirschnick LB, Schuch LF, Cademartori MG, Vasconcelos ACU. Metastasis to the oral and maxillofacial region: A systematic review. Oral Dis 2020; 28:23-32. [DOI: 10.1111/odi.13611] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Laura Borges Kirschnick
- Diagnostic Center for Oral Diseases School of Dentistry Universidade Federal de Pelotas Pelotas Brazil
| | - Lauren Frenzel Schuch
- Department of Oral Diagnosis Piracicaba Dental School Universidade de Campinas Piracicaba Brazil
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