Oral metastases from carcinoma of cervix

Incidence rate of metastases in the oral cavity: a review of all metastatic lesions in the oral cavity

Background

Metastases in the oral cavity are rare and account for only 1 to 3% of all malignant lesions in this area. The primary location from which most metastases have been described in the oral cavity in adult patients include lungs, breasts, kidneys and colon.

Material and Methods

A systematic search of the literature was carried out following the PRISMA statement in PubMed database. Clinical trials and case series published in the last 10 years [2010-2020] were eligible to be selected. The headings and keywords used in the searches were “cancer” AND “oral metastases”, “incidence” AND “oral metastases”, “oral metastases” AND “jaw bone”, “oral metastases” AND “soft tissue”.

Results

For the study of the incidence of metastases in the oral cavity, 9 reports of clinical trials and 7 retrospective studies of case series have been included in this article. The primary locations from which more metastases have been described in the oral cavity are lungs (30.6% or 183 cases), breasts (22.2% or 133 cases), liver (15.5% or 93 cases), prostate (9 % or 54 cases), thyroid glands (8.1% or 49 cases), kidneys (7.3% or 44 cases), skin (2.3% or 14 cases), soft tissues (2% or 12 cases), colon (2% or 12 cases) and gastrointestinal (0.6% or 4 cases). These metastases have a predilection for hard tissues. The clinical presentation of these lesions varies from painless granulomatous lesions to lytic areas in the jaws.

Conclusions

Although metastases in the oral cavity is an uncommon pathology, early diagnosis is needed so that in the event that it is the first manifestation, it allows the primary tumor to be diagnosed as soon as possible.

Key words:Cancer, oral metastases, incidence, jaw bone, soft tissue.

Diagnosis of an adenocarcinoma of Müllerian origin made as a result of its metastasis in the mouth floor

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.

Postoperation of cervical cancer with intestine metastasis: a case report and literature review

Background

Cervical cancer can infiltrate locally and directly spread to adjacent organs including the vagina, peritoneum, urinary bladder, ureters, rectum, and paracervical tissue, but the intestine metastasis from cervical cancer is extremely rare, which can easily be misdiagnosed.

Case presentation

Here, we report a case about a 45-year-old postoperative cervical cancer patient with metastases to small intestine and sigmoid colon who presented abdominal distention and dull pain due to intestinal obstruction. The patient underwent exploratory laparotomy, and two intestinal segments including the tumors were resected. The postoperative pathological diagnosis illustrated sigmoid colon and terminal ileum metastatic squamous cell carcinoma.

Conclusions

This case demonstrates that intestine metastasis must be considered in the differential diagnosis of acute abdomen in patients with cervical cancer even at an early tumor stage.

Carcinoma of breast metastasising to mandible

Metastatic tumours to oral cavity from distant sites are rarely seen. Bones are frequently involved as compared to soft tissues. Clinical presentation may vary according to site and size of metastatic tumour. We present a case of carcinoma of breast in a 50-year-old woman, metastasising to mandibular ramus, condyle and surrounding soft tissue structure presenting as osteomylitis of condyle.

Mandibular metastasis from a pulmonary squamous cell carcinoma

Metastatic tumors to the jaws and oral tissues are rarely encountered, accounting for less than 1% of all malignant tumors affecting the mouth. Although, metastasis to the mandible from a pulmonary carcinoma is extremely rare, when it does occur it mimics more common pathoses such as odontogenic cysts, osteomyelitis, space infections making its diagnosis even more challenging. Metastasis should be taken into account especially in patients with chronic history of smoking and sudden onset of paresthesia. The rarity of such cases has also resulted in there being no definitive consensus on managing them.