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Bruckmann M, Brenet E, Boulagnon-Rombi C, Louvrier A, Mauprivez C. Effectiveness of immune checkpoint inhibitors in the treatment of kidney cancer oral metastasis. A case report. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024:101913. [PMID: 38719194 DOI: 10.1016/j.jormas.2024.101913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 05/06/2024] [Indexed: 05/21/2024]
Abstract
Oral cavity metastasis from renal cell carcinoma is rare with poor prognosis. Recently immune checkpoint inhibitors (ICIs) have shown promising outcomes in the treatment of advanced RCC. Herein, we report a case of palatal lesion mimicking vascular tumor in a 60-year-old woman with locally advanced kidney cancer (T3aN0M0). She underwent an excisional biopsy, and histopathological examinations revealed an oral metastasis from clear cell renal cell carcinoma (ccRCC). The patient was treated with a combination of two ICIs with nivolumab, a programmed death 1 (PD-1), and ipilimumab, a cytotoxic T-lymphocyte-associated antigen 4 (CTLA4). After 3 cycles of systemic immunotherapy, the palate was completely well healed and after 13 months of follow-up, there was no evidence of recurrence. Regarding treatments, radical surgery is often recommended due to a high local control in case of solitary lesions or oligo-metastases. However, this option therapy is associated with a poor quality of life. To the best of our knowledge, this is the first case to suggest the benefits of ICIs in the treatment of oral metastases from ccRCC. Combining ICIs with conservative surgery could be another treatment option for oral metastasis in patients with renal cell carcinoma.
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Affiliation(s)
- M Bruckmann
- Service d'Oto-Rhino-Laryngologie, CHU de Reims, F-51100 Reims, France
| | - E Brenet
- Service d'Oto-Rhino-Laryngologie, CHU de Reims, Université de Reims Champagne-Ardenne, Laboratoire EA4691 (BIOS), F-51100 Reims, France
| | - C Boulagnon-Rombi
- Université de Reims Champagne-Ardenne, UMR CNRS 7369, CHU Reims, Laboratoire de Pathologie, F-51100, Reims, France
| | - A Louvrier
- CHU Besançon, Chirurgie maxillo-faciale, stomatologie et odontologie hospitalière, Université de Franche-Comté, SINERGIES, F-25000 Besançon, France.
| | - C Mauprivez
- Service de Chirurgie Orale, Pôle de Médecine Bucco-Dentaire, CHU de Reims, Université de Reims Champagne-Ardenne, Laboratoire EA4691 (BIOS), F-51100 Reims, France
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Turgeman S, Turgeman I, Emodi O, Wolff A, Rachmiel A. Impact of Early Diagnosis of Maxillofacial Metastases on Treatment and Patient Outcomes - A Retrospective Study. Ann Maxillofac Surg 2024; 14:66-70. [PMID: 39184420 PMCID: PMC11340852 DOI: 10.4103/ams.ams_183_23] [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: 09/26/2023] [Revised: 05/27/2024] [Accepted: 06/03/2024] [Indexed: 08/27/2024] Open
Abstract
Introduction Maxillofacial metastases from distant primary sites account for less than 1% of cancer in the head-and-neck region and are often misdiagnosed as benign or inflammatory conditions. The purpose of this study was to describe the clinical characteristics of patients with maxillofacial metastases, treatment and outcomes. Materials and Methods Subjects with head-and-neck cancer were identified from the institutional database. Descriptive statistics were employed. Results Of 532 patients with head-and-neck cancer between 2008 and 2020, 15 (2.8%) had histologically verified metastatic lesions, of which 53.33% males with a mean age of 69 years. The median time from symptom onset to diagnosis was 17 days (range: 7-60). The mandible was the most common location (40%), followed by the parotid gland (33.33%) and maxilla (13.33%). Adenocarcinoma was the most frequent histology (60%), and half of the patients had extraoral manifestations. Tumour origin was gastrointestinal, lung (33.33% each), prostate (20%) and breast (13.3%). No predilection for tumour type or histology and location were seen. Radiographic features were non-specific, with computed tomography (CT) demonstrating periosteal reaction, bone expansion and lytic lesions and high variability in Positron Emission Tomography (PET) standardised uptake value (minimum: 2.0, maximum: 10.93 and mean: 4.14). Diagnosis led to altered treatment in 60%, more in extraoral than intraoral manifestations (71% vs. 37.5%); 40% received radiotherapy, 20% systemic treatment and none underwent surgery. Over half of the patients passed away within 6 months, median survival was 5 months, shorter in patients with intraoral than extraoral disease (3 vs. 13.2 months, P < 0.05). Discussion Maxillofacial metastases have elusive manifestations and often warrant specific treatment. Prospective data should evaluate associations between timely diagnosis and symptomatic improvement and survival.
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Affiliation(s)
- Shahar Turgeman
- Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Ilit Turgeman
- Department of Oncology, Cancer Center, Emek Medical Center, Afula, Israel
| | - Omri Emodi
- Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Amir Wolff
- Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Adi Rachmiel
- Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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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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Oliveira Filho OVD, Oliveira DMDA, Medeiros YDL, Pinto CAL, Alves FA, Jaguar GC. Tongue enlargement associated with burning sensation: An atypical case of breast cancer metastasis. Oral Oncol 2023; 146:106565. [PMID: 37683334 DOI: 10.1016/j.oraloncology.2023.106565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 09/03/2023] [Indexed: 09/10/2023]
Affiliation(s)
| | | | | | | | - Fabio Abreu Alves
- Department of Stomatology, A.C.Camargo Cancer Center, São Paulo, SP, Brazil; Department of Stomatology, School of Dentistry, São Paulo University, São Paulo, SP, 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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