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Labrador AJP, Marin NRG, Valdez LHM, Sanchez KBT, Zabarburu W, Ibazetta KAR, Garcia AER, Cabezas DM, Romero L, Conte AM, Wright JM. Metastasis to the oral and maxillofacial region. A systematic review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e474-e483. [PMID: 34933137 DOI: 10.1016/j.jormas.2021.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/06/2021] [Accepted: 12/15/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Metastasis to oral and maxillofacial region (MOMFR) is an unusual finding; representing between 1 and 1.5% of all malignancies in the maxillofacial region. A systematic review is presented to determine trends in presentation, diagnostic features, and patient outcome. METHODS Searches of databases were carried out for papers reporting MOMFR. The variables were demographics, patient symptoms, tumor location, tumor size, histopathology, origin of the tumor, immunohistochemical studies, follow-up and survival. RESULTS 696 cases were identified; 391 males, and 305 females. The most common race was white. The most common primary tumor for females was from breast 31.1% (n = 95), for males from lung 20.5% (n = 143). The most common location was the mandible 44.9% (n = 313), followed by gingival soft tissue 16.8% (n = 117). A frequent clinical symptom was pain with 17.5% (n = 122). The most common clinical presentation was a mass or tumor 37.4% (n = 260). The mean age was 58.8 years. The average time before diagnosis was 10.3 months, the mean follow-up after diagnosis was 13.1 months, and the average survival was 9.8 months. CONCLUSION MOMFR shows a strong predilection for the posterior mandible, with a mass or tumor being the most common clinical presentation. They are frequently painful, and demonstrate a poor prognosis.
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Affiliation(s)
- Alberto Jose Peraza Labrador
- Oral surgeon and oral pathologist director centro de odontologia integral acarigua, Mailing address: av 5 de diciembre cc metropolitan local 6, Venezuela.
| | | | - Luciano Hermios Matos Valdez
- Oral Patohology director. Diagnocentrobucal, Mailing address: Las Golondrinas Mz. B lote 9, Los Olivos, Lima, Peru
| | - Katman Bear Toledo Sanchez
- Resident oral pathology program cayetano Heredia peru. Oral and maxilofacial pathology and medicine clinics, Mailing address: Av. El Olivar, 3879 San Martin de Porres, Lima, Peru
| | - Wil Zabarburu
- Director of Dental healthcare clinic, Av principal Lote 7. Micaela Bastidas 2, Lima, Peru
| | - Karem Annelise Rodriguez Ibazetta
- Associated of Oral and maxilofacial pathology and medicine clinics department. Mailing address: Av. Pablo Carriquiry 705, San Isidro, Lima, Peru
| | - Alejandra Elvia Ruiz Garcia
- Director Oral and maxilofacial pathology and medicine clinics. Mailing address: Cooperativa Santa Polonia Mz. N lote 15, San Martin de Porres, Lima, Peru
| | - Dayana Mamani Cabezas
- Director associated. Oral and maxilofacial pathology and medicine clinics. Mailing address: Av. Petrolera km 4 Zona Sud OTB Villa San Miguel, Cochabamba, Bolivia
| | - Leonardo Romero
- Dircetor of the Oral prostodontic department. Romedent dental clinic, Bogotá, Colombia
| | - Aldo Manzur Conte
- Director of endodontic department. Savanna Dental Group, 1135 Adelaide St. North suite 303, London, Ontario N5Y 5K7, Canada
| | - John M Wright
- Department of Diagnostic Sciences, Texas A&M University College of Dentistry, 3302 Gaston Ave, Dallas, TX 75246, United States
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Moraes RM, Alves FA, Carvalho BFDC, Costa FD, Lopes RN, Jaguar GC. Mandible metastasis of small cell lung cancer mimicking a residual cyst. Autops Case Rep 2017; 7:37-41. [PMID: 28536686 PMCID: PMC5436920 DOI: 10.4322/acr.2017.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Accepted: 01/19/2017] [Indexed: 11/24/2022]
Abstract
Small cell lung carcinoma (SCLC) is an uncommon tumor characterized by an aggressive behavior with early metastasis, usually to the contralateral lung, liver, brain, and bones. There are only five cases of this particular tumor metastasizing to the oral cavity described in the English literature. We present the case of metastatic SCLC in the mandible with radiographic findings resembling a residual cyst. A 66-year-old man with previous diagnosis and treatment for a SCLC was referred to the Stomatology Department with a history of persistent pain in the mandible 1 year after the inferior right pre-molar tooth extraction. The radiographic exam showed a well-delimited radiolucent area on that extracted tooth’s region resembling a residual cyst. Biopsy was performed yielding the diagnosis of metastatic SCLC. The patient was referred to the clinical oncologist for chemotherapy. Although uncommon, this tumor should be included in the differential diagnosis of jawbone lesions, particularly when the patient presents a previous diagnosis of SCLC.
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Affiliation(s)
| | - Fabio Abreu Alves
- Stomatology Department - A.C. Camargo Cancer Center, São Paulo/SP - Brazil.,Stomatology Department - Universidade de São Paulo, São Paulo/SP - Brazil
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Lee YH, Lee JI. Metastatic carcinoma of the oral region: An analysis of 21 cases. Med Oral Patol Oral Cir Bucal 2017; 22:e359-e365. [PMID: 28390123 PMCID: PMC5432085 DOI: 10.4317/medoral.21566] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Accepted: 01/30/2017] [Indexed: 12/16/2022] Open
Abstract
Background Metastatic carcinoma to the jaws and oral region are very rare, representing less than 1% of all oral tumors. Unfortunately, oral metastasis is usually manifestation of an advanced stage of primary cancer, and indicates widespread disease and poor prognosis. Material and Methods In this retrospective study, a total of 2039 patients with history of oral malignant tumor between 1980 and 2012 at Seoul National University Dental Hospital were evaluated. We analyzed the dental and medical records, and histopathological database of 2039 patients to assess the prevalence of oral metastasis of carcinoma in terms of sex and age, as well as, the most common origin of primary cancer, and prevalent site and histopathological type of metastatic carcinoma. Results Among 2039 patients, 21 (1.03%) were finally diagnosed with metastatic carcinoma of the jaws and oral region. Among the 21 patients, only 11 had a working diagnosis as oral metastasis upon clinical evaluation before performing a biopsy. The mean age at the time of diagnosis with a metastatic carcinoma was 56.86, and there was a male preponderance. Metastatic carcinoma was more frequent in the jaws than in the soft tissue, especially in the mandible compared to the maxilla. The most frequent primary site was the lungs, followed by the liver and breasts. The predominant histopathological types were hepatocellular carcinoma and adenocarcinoma. Patient outcomes indicated a poor prognosis with the time from the appearance of the metastasis to death was only 12 months. Conclusions According to these cases, oral metastases of carcinoma were exceedingly rare in Koreans. It can allow the clinicians take into account the possible presence of metastases and lead to early diagnosis. Key words:Metastasis, jaws, oral region, mandible, Korean.
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Affiliation(s)
- Y-H Lee
- 613 Kyunghee University Dental Hospital, Hoegi-dong, Dongdaemun-gu, Seoul, Korea,
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Irani S. Metastasis to the oral soft tissues: A review of 412 cases. J Int Soc Prev Community Dent 2016; 6:393-401. [PMID: 27891304 PMCID: PMC5109852 DOI: 10.4103/2231-0762.192935] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 07/22/2016] [Indexed: 12/17/2022] Open
Abstract
The present review article analyzes the characteristics of metastases to the oral soft tissues from 1937 to 2015. An extensive literature search was performed. All variables such as age, gender, and primary and secondary tumor sites were analyzed. Metastases to the major salivary glands were not included in this review. In general, there were 412 metastatic lesions developed in the oral soft tissues. The male-to-female ratio was approximately 1.8:1. The mean age of the patients at diagnosis was 58. The lung was the most common primary site and the gingiva was the most common metastatic site. The greater part of the histological examination yielded adenocarcinoma. The diagnosis of a metastatic lesion in the oral cavity is a challenge to the clinicians due to the lack of pathognomonic signs and symptoms. Oral metastases usually occur in the advanced stages of cancers, and the interval between appearance and death is usually short. The oral soft tissue metastasis can be easily recognized compared to the metastasis of jawbones. Early detection of oral lesions is important in the case of being the first sign of a malignancy in other parts of body.
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Affiliation(s)
- Soussan Irani
- Dental Research Center, Department of Oral Pathology, Dental Faculty, Hamadan University of Medical Sciences, Hamadan, Iran
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5
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Hassona Y, Hughes C, Prime SS. Metastatic tumours of the tongue. Oral Oncol 2011; 47:308-11. [PMID: 21354854 DOI: 10.1016/j.oraloncology.2011.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Revised: 01/27/2011] [Accepted: 01/30/2011] [Indexed: 11/16/2022]
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Shen ML, Kang J, Wen YL, Ying WM, Yi J, Hua CG, Tang XF, Wen YM. Metastatic tumors to the oral and maxillofacial region: a retrospective study of 19 cases in West China and review of the Chinese and English literature. J Oral Maxillofac Surg 2009; 67:718-37. [PMID: 19304027 DOI: 10.1016/j.joms.2008.06.032] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2007] [Revised: 02/28/2008] [Accepted: 06/16/2008] [Indexed: 01/12/2023]
Abstract
PURPOSE The aim of this article was to obtain an overview of metastatic tumors to the oral and maxillofacial (OMF) region, especially the differences in the constituent ratios of primary cancers between the United States and China. PATIENTS AND METHODS Clinical findings of 19 cases encountered in West China Hospital of Stomatology were summarized and the English and Chinese literature were reviewed and analyzed. The main clinical features of OMF metastases were summarized, with an emphasis on primary cancers' constituents. RESULTS The lung, breast, kidney, liver, and prostate were the top 5 common primary sites of cancer. However, there was a significant difference in the primary cancers' constituents between United States and China (P < .001). The breast, kidney, prostate cancers, and melanoma of skin were more frequent primary cancers in United States than in China, whereas that of the lung, thyroid, liver, esophagus, and the stomach were more common in China than in United States. The proportions of the OMF metastatic lesions originating in the lung, kidney, liver, thyroid, and esophagus in all OMF metastatic tumors were higher than the corresponding primary cancers' prevalent proportions. CONCLUSIONS The frequency of developing OMF metastasis is not always consistent with primary cancers' prevalence, which suggests that different cancers have different potentiality to develop OMF metastasis. Cancers of the kidney, liver, lung, thyroid, and esophagus were more likely to spread to the OMF region. In general screening of primary cancer, it would be helpful to take into account the metastatic potentiality of different cancers and primary cancers' prevalence in different countries in the case of occult primary.
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Affiliation(s)
- Mo-Lun Shen
- Master of Medicine, Department of Head and Neck Oncology, West China College of Stomatology, Sichuan University, Chengdu, China
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8
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Kurt M, Bulut N, Aksoy S, Kosemehmetoglu K, Kars A. Anterior tongue metastasis from lung cancer. South Med J 2006; 99:784-5. [PMID: 16866071 DOI: 10.1097/01.smj.0000224129.90177.2f] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Gupta S, Shahid N, Fouracres M. Uncommon metastatic site from vulval carcinoma: the tongue. J OBSTET GYNAECOL 2005; 25:733-4. [PMID: 16263564 DOI: 10.1080/01443610500307680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- S Gupta
- Department of Obstetrics and Gynaecology, South Manchester University Hospital, Manchester, UK.
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Terashima T, Matsuzaki T, Kawada I, Nishida J, Tanaka Y, Morishita T, Takeyasu Y, Yamane GY, Uchiyama T. Tongue metastasis as an initial presentation of a lung cancer. Intern Med 2004; 43:727-30. [PMID: 15468975 DOI: 10.2169/internalmedicine.43.727] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Metastasis to the tongue seldom occurs, and lingual metastasis as an initial sign of cancer occurs even less frequently. We report a case of lung cancer in which the patient's initial symptom was related to the tongue metastasis. A 63-year-old man had a submucosal tumor on the left posterolateral aspect of the tongue and a biopsy specimen of the tongue tumor showed poorly differentiated squamous cell carcinoma. A chest X-ray showed a mass in the right lung and cytological examination of the specimen obtained by bronchial brushing showed poorly differentiated squamous cell carcinoma, whose appearance was similar to that of the tongue. Based on these findings, the tongue lesion was diagnosed a metastatic tumor from the lung cancer. The patient received radiation therapy combined with systemic chemotherapy, however, he died 5 months after the diagnosis of lung cancer. An autopsy revealed a lung cancer in the right lower lobe with metastatic tumors in the tongue, right middle lobe, left upper lobe, liver, adrenal gland, pericardium, heart, and subcutaneous tissues. No other possible primary cancer that may have been the cause of the metastases was identified.
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Affiliation(s)
- Takeshi Terashima
- Department of Internal Medicine, Ichikawa General Hospital, Tokyo Dental College, 5-11-13 Sugano, Ichikawa, Chiba 272-8513
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Jayasooriya P, Gunarathna I, Attygalla A, Tilakaratne W. Metastatic renal cell carcinoma presenting as a clear cell tumour in the head and neck region. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/j.ooe.2003.12.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Dysphagia occurs in only a small percentage of patients with lung cancer, but the frequency of this cancer means that large numbers are affected. Non-quantitative analysis of a large Scottish series of lung cancer cases indicates the following eight broad categories of dysphagia according to underlying mechanisms: mediastinal disease; cervical lymphadenopathy; brainstem lesions; gastrointestinal tract metastases; associated systemic disorders; second primaries; oropharyngeal and oesophageal infections; and radiation-induced oesophageal toxicity.
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Affiliation(s)
- D R Camidge
- Department of Oncology, Western General Hospital, Edinburgh EH4 2XU, Scotland, UK.
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13
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Abstract
Tongue swellings and growths are traditionally evaluated by surgical biopsy. Most of them, however, are easily accessible by fine-needle aspiration (FNA). We reviewed 75 lesions presenting as tongue swellings, which were examined by fine-needle aspiration cytology (FNAC) in our institutions over a period of 11 yr. The lesions included 17 malignant tumors: 12 cases of squamous carcinoma (SQC), 2 metastases, and 3 non-Hodgkin's lymphomas (NHL). In addition, 15 benign tumors and 43 nonneoplastic benign conditions were found. Thirteen of the 17 malignant lesions were diagnosed cytologically as malignant, 3 as suspicious for malignancy, and 1 as atypical, with biopsy recommended. There were no false-positive diagnoses. There were no clinical complications resulting from FNA. We conclude that FNAC of the tongue permits rapid and reliable diagnosis, and we recommend this method as the first diagnostic step in the evaluation of tongue swellings.
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Affiliation(s)
- H A Domanski
- Department of Pathology and Cytology, Central Hospital, Kristianstad, Sweden
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14
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Abstract
Tongue swellings and growths are traditionally evaluated by surgical biopsy. Most of them, however, are easily accessible by fine-needle aspiration (FNA). We reviewed 75 lesions presenting as tongue swellings, which were examined by fine-needle aspiration cytology (FNAC) in our institutions over a period of 11 yr. The lesions included 17 malignant tumors: 12 cases of squamous carcinoma (SQC), 2 metastases, and 3 non-Hodgkin's lymphomas (NHL). In addition, 15 benign tumors and 43 nonneoplastic benign conditions were found. Thirteen of the 17 malignant lesions were diagnosed cytologically as malignant, 3 as suspicious for malignancy, and 1 as atypical, with biopsy recommended. There were no false-positive diagnoses. There were no clinical complications resulting from FNA. We conclude that FNAC of the tongue permits rapid and reliable diagnosis, and we recommend this method as the first diagnostic step in the evaluation of tongue swellings.
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Affiliation(s)
- H A Domanski
- Department of Pathology and Cytology, Central Hospital, Kristianstad, Sweden
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15
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Ruby SG, Kish JK. Oncocytic adenocarcinoma of minor salivary gland. An unusual glossal presentation of a minor salivary gland tumor. Pathol Res Pract 1996; 192:856-64; discussion 865-8. [PMID: 8897522 DOI: 10.1016/s0344-0338(96)80061-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A case of an unusual oncocytic variant of minor salivary gland adenocarcinoma presenting in the base of the tongue in a 79 year old male with a remote history of regional radiotherapy is presented. The tumor had a striking morphologic similarity to the more common granular cell tumor, with which it could have been easily confused, leading to significant misdiagnosis. The light microscopic, cytologic, immunohistochemical and electron microscopic features are presented, with a discussion of the differentiating features of this lesion compared to other more common benign and malignant glossal tumors.
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Affiliation(s)
- S G Ruby
- Hinsdale Hospital, Department of Pathology, Illinois, USA
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Abstract
A review of the English-language literature revealed 157 well-documented cases of metastatic lesions to the oral mucosa. Most (64%) were diagnosed in patients in their fifth to seventh decade. The frequency of the primary site differed between genders: for men it was the lung (35.5%) followed by the kidney (16%) and skin (15%); for women it was the breast (24%) followed by the genital organs (17%). The most common oral site was the gingiva and alveolar mucosa (54.8%) followed by the tongue (27.4%), and with much less frequency by the tonsil, palate, lip, buccal mucosa and floor of the mouth. Of the dentulous patients, 79% exhibited the metastatic tumor in the attached gingiva. The clinical appearance of the metastatic oral lesion in most cases resembled hyperplastic or reactive lesions.
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Affiliation(s)
- A Hirshberg
- Department of Oral Pathology and Oral Medicine, Maurice and Gabriela School of Dental Medicine, Tel Aviv University, Israel
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O Carroll MK, Krolls SO, Mosca NG. Metastatic carcinoma to the mandible. Report of two cases. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1993; 76:368-74. [PMID: 8378053 DOI: 10.1016/0030-4220(93)90270-e] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Two cases of rare metastases from malignant neoplasms to the posterior mandible in young adults are reported. Multiple imaging modalities were necessary to identify the many metastases and, in one case, the suspected primary site. Many of the radiographic images are presented for that case.
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Affiliation(s)
- M K O Carroll
- School of Dentistry, University of Mississippi Medical Center
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Abstract
5% of all malignancies involve the oral cavity. One percent of these malignancies are secondary to neoplasms that are usually found below the level of the clavicles. As it is widely accepted that the jaws do not contain a lymphatic system, it is believed that metastases there occur via the blood stream, a fact that is supported by the occurrence of metastatic foci in areas where spongiosa and slowing of the circulation favour the entrapment of metastatic emboli. This however does not explain why most of the metastases occur in the lower jaw (and in particular in the premolar-molar area) and not in the maxilla, where the spongiosa is more abundant. Batson's plexus has also been mentioned as a possible route of metastasis to the head and neck, thus explaining why, in some cases of metastases, the lungs are not involved, as the blood has not been filtered through the pulmonary bed before reaching the head and neck. In our review of the literature we found 422 metastatic lesions in the mouth, jaws and the surrounding tissues in 365 patients equally divided between men and women. 56.5% of the cases were above the age of 50. In 228 cases there were other metastases as well, whereas in 114 cases the only metastasis found was the one under study. In 22% of the cases, the metastatic focus in our area was the first indication of the existence of an undiagnosed primary malignant tumour somewhere else.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- N Zachariades
- Oral and Maxillofacial Clinic, General Peripheral Hospital of Attica, Kifissia, Athens, Greece
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Abstract
A case report of a patient with carcinoma of the rectum with metastasis to the tongue clinically mimicking a primary tongue neoplasm is described. The patient presented with an ulcer in the tongue three years after undergoing an anterior resection for a Dukes C carcinoma of the rectum. Other asymptomatic metastatic lesions were discovered only after the histology report suggested that the tongue ulcer biopsy was metastatic in origin. Metastatic tumour to the tongue is extremely rare and often occurs at a late stage, when there is disseminated disease. We are not aware of any reported case of tongue metastasis from carcinoma of the rectum.
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Affiliation(s)
- N G Davidson
- Department of Radiotherapy and Oncology, Leicester Royal Infirmary
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Approach to the Patient with Lung Cancer. Lung Cancer 1985. [DOI: 10.1007/978-3-642-82234-6_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Grace A, Drake-Lee A, Conn P, Kalinkiewicz M, Moffat D. Metastatic lingual carcinoma masquerading as Ludwig's angina. J Laryngol Otol 1984; 98:535-7. [PMID: 6715987 DOI: 10.1017/s0022215100147036] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Abstract
A case of histiocytic lymphoma primarily involving the tongue in a 71-year-old black man is presented. The authors discuss the diagnostic problems in differentiation of such lesions from other small-cell tumors, primary or secondary, that might involve the tongue. Electron microscopic studies were utilized to confirm the diagnosis of histiocytic lymphoma.
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Batsakis JG. The pathology of head and neck tumors: the occult primary and metastases to the head and neck, Part 10. HEAD & NECK SURGERY 1981; 3:409-23. [PMID: 7239939 DOI: 10.1002/hed.2890030511] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Metastases from carcinomas to the head and neck, either to lymph nodes or to extranodal sites, arise most often from known primary neoplasms. However, some are from a clinically inapparent neoplasm--the so-called occult primary. If the metastasis is an epidermoid carcinoma in a lymph node, the odds clearly favor the primary being in the upper aerodigestive tract. The success rate of discovery is variable, however, and a significant number of primaries remain undetected. Metastatic adenocarcinomas, to either nodal or extranodal sites, are most often from infraclavicular neoplasms. In general, the incidence of metastases to the head and neck from visceral primaries below the clavicle follows the general incidence of the primary cancer itself. Renal-cell carcinoma is the exception since its frequency of metastases to the head and neck exceeds the expected incidence in the general population. Branchiogenic carcinoma is more a conceptual than a literal clinicopathologic entity. The diagnosis should be made with reluctance and only after fulfillment of several rather stringent criteria.
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Kaugars GE, Svirsky JA. Lung malignancies metastatic to the oral cavity. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1981; 51:179-86. [PMID: 6937841 DOI: 10.1016/0030-4220(81)90037-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
An analysis of intraoral metastatic lesions from lung cancers reported in the English-language literature was surveyed. Thirty-seven acceptable cases were found, and an additional case is presented. The average age of these cases was 54.0 years, with a marked male predilection. In a significant number of cases (48.6 percent) appearance of the intraoral metastases preceded discovery of the primary lesion. The mandible was the most common site of involvement (55.2 percent) and the symptoms were quite variable. Our results did not support a "seeding" hypothesis whereby sputum-borne cancer cells settle out in areas of traumatized tissue.
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