Maxillary metastasis of transitional cell carcinoma: report of a case

Unusual Cervical Lymph Node Metastasis of Papillary Urothelial Carcinoma

Papillary urothelial carcinoma is aggressive and characterized by frequent metastasis to distant sites at an early stage. Papillary urothelial carcinoma of the urinary bladder usually metastasizes to the local lymph nodes, liver, lungs, bone, and mediastinum. Urogenital tract carcinoma of the head and neck metastasis is uncommon and rarely reported to the cervical lymph nodes. We present a case of cervical lymph node metastasis of papillary urothelial carcinoma of the urinary bladder.

Rare Manifestation of the Cutaneous and Cervical Lymph Node Metastases of Urothelial Carcinoma of Urinary Bladder: A Case Report

Lymph node metastasis from bladder cancer mainly involves the external/internal iliac and obturator nodes as the primary lymphatic drainage sites of the bladder, and common iliac sites as the secondary drainage. Lymph node involvement above the diaphragm is rare. Metastasis to the head and neck region is associated with poor prognosis and low survival rate. Herein, we report a case of cervical cutaneous and lymph node metastases in a patient with bladder cancer. This is a rare case of advanced urothelial carcinoma presenting as an aggressive inflammatory process with extensive lymph node involvement, without bony or visceral metastasis.

Mandibular Metastasis of a Recurrent Poorly Differentiated Urothelial Bladder Carcinoma

Metastatic lesions to the oral cavity are uncommon; they represent between 1 and 3% of all malignant oral neoplasms. In this article, we report a rare case of metastatic urothelial bladder carcinoma in the mandible detected on oral radiographic images and confirmed with multiple imaging modalities. A 67-year-old woman presented to our clinic suffering from pain in the right side of the mandible with a mild swelling. Panoramic radiograph revealed an ill-defined relatively radiolucent lesion in the right mandibular premolar-canine region presenting with permeative changes. Cone-beam computed tomography showed a relatively hypodense lesion with demineralization, interruption of the buccal cortices, and slight thickening and sclerosis of the buccal cortical bone. The patient was referred for further evaluation including additional advanced imaging radiographic techniques (MRI and PET scan) and clinical and histopathological examinations that lead to a final diagnosis of metastatic lesion from an underlying urothelial bladder carcinoma.

Non-Muscle Invasive Papillary Urothelial Carcinoma Metastatic to the Mandible

Urothelial carcinoma, the most common histologic subtype of bladder cancer in the United States, most frequently presents as non–muscle invasive disease. Initially, therapy involves transurethral endoscopic resection and subsequent intravesical therapies with extended surveillance for high-risk disease. Even with the best treatments, recurrence and progression can occur. However, metastasis of non–muscle invasive bladder cancer to distant sites without evidence of progression or regional metastasis is rare. In this article, we present the case of a patient with high-grade papillary urothelial carcinoma who developed an unusual metastasis to the mandible, confirmed by GATA-3 immunostaining, over 4 years after initial transurethral resection. Prior to the development of metastatic disease, this patient had no evidence of local recurrence during maintenance Bacillus Calmette-Guerin intravesical therapy and concurrent surveillance. Positron emission tomography-computed tomography taken after presentation with mandibular metastasis did not show any evidence of regional metastasis. This case highlights an unusual location for distant metastasis of urothelial carcinoma occurring in a patient without evidence of muscle invasive disease or regional metastasis. We additionally highlight the utility of GATA-3 immunostaining in identifying urothelial carcinoma histologically.

Metastasis to the Jawbones: A review of 453 cases

The purpose of the present article was to review the characteristics of the jawbone metastases to analyze all variables. A relevant English Literature search in PubMed, Scopus, and Google Scholar was performed. All variables such as age, gender, primary and secondary tumor sites were analyzed. There were 453 metastatic cases. The male-to-female ratio was 1.2:1, and the mean age of the patients was 53.4 years. The lung was the most common primary site in men, and breast in women. The most common metastatic site was the mandible, and adenocarcinoma was the most frequent histological diagnosis. Metastases to the jaw bones occur in the advanced stages of a malignancy hence; a careful examination of patients with jaw bone lesions is strongly suggested. Dentists, as well as general physicians, should take into consideration the possible presence of jaw metastases in cases which present atypical symptoms, especially in patients with known malignant disease.

High-grade urothelial carcinoma with squamous differentiation metastasizing to the tongue

Tumors metastasizing to the head and neck region are uncommon. Metastasis of urothelial carcinoma to the maxillofacial region is exceedingly rare and mostly involves the jaw. We present a case of urothelial carcinoma metastasizing to the tongue. Immunohistochemistry in conjunction with fluorescent in situ hybridization was used to confirm the relation between the primary and metastatic lesions, making it the first such reported case employing the UroVysion (Catalogue number 02 J27-025, Abbott Molecular Inc., Des Plaines, IL, USA) fluorescent in situ hybridization probe in a metastatic lesion in the head and neck region.

Metastasis of genitourinary tumors to the head and neck region

The objective of the present study is to characterize genitourinary tumors (GU) metastatic to the head and neck and to determine long-term prognoses. Using a retrospective chart review of 734 patients treated between January 1995 and May 2005 with an ICD-9 code pertaining to a metastatic head and neck cancer, we found 37 patients with primary GU tumors. There were 24 cases of prostate cancer, 10 cases of renal cell carcinoma, and 4 cases of transitional cell carcinoma. Sixteen of 24 patients (67%) with prostate cancer had a cranial metastasis while 6 of 9 (67%) patients with renal cell carcinoma had cerebral metastasis. We concluded that prolonged survival is possible in prostate cancer patients treated aggressively with radiation and chemotherapy, indicating that early detection and aggressive screening are important in these patients.

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

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.

Metastatic transitional cell carcinoma of the urinary bladder presenting as a mandibular gingival swelling

Oral cavity metastases mostly originate from the breasts, lungs, or kidneys. Transitional cell carcinoma (TCC), the most frequent malignant tumor of the urinary bladder, rarely metastasizes to the jaws. To the best of our knowledge, only 8 cases of bladder carcinoma have been reported in the English literature to metastasize to the jawbones. A new case of mandibular metastasis of urinary bladder TCC with extension to the gingiva is presented in a 64-year-old white man. The patient was referred for a periodontal infection of the upper right first molar. The clinical examination also showed a gingival swelling located in the lower left premolar region with a hypoasthesia of the left side of the lower lip. The gingival mass was biopsied, and the microscopy showed a mandibular metastatic TCC of the urinary bladder extending to the gingiva. Periodontists should be aware that, although gingival metastases are rare, when they occur they may mimic other local benign pathological conditions.

Metastatic follicular thyroid carcinoma to the maxilla

We present a unique case of metastatic follicular thyroid carcinoma to the hard palate and the maxillary sinus, a case that to our knowledge has not been reported before. Various malignant tumours that metastize to the maxilla are reviewed, and the therapeutic approach to follicular thyroid carcinoma metastasis to that area is also discussed. Follicular thyroid carcinoma should be included in the list of tumours that metastasize to the maxilla.

Metastatic tumors to the jawbones: analysis of 390 cases

A review of the English language literature revealed 390 well-documented cases of metastatic lesions to the jawbones. Most metastatic lesions were diagnosed in patients in their fifth to seventh decade. The primary site differed between the genders: for women, it was the breast followed by the adrenal, colo-rectum, female genital organs and thyroid; for men, it was the lung, followed by the prostate, kidney, bone and adrenal. The most common location of the metastatic tumors was the mandible, with the molar area the most frequent site involved. In about 30% of cases the oral lesion was the first sign of the malignant disease. The present data are compared with those of metastatic tumors to the oral mucosa and a view on the possible pathogenesis is presented.

Metastatic tumors to postextraction sites

Review of the literature revealed 55 cases where tooth extraction preceded the discovery of metastases. The lung and breast were the most common sources of the metastasis, and the mandibular premolar area was the most common site. A soft tissue mass extruding from a recent extraction wound, and accompanied by pain, were the main symptoms in most patients. The mean time from discovery of the metastasis to death was 3.8 months. Tooth extraction appears to serve as a promoting factor in the metastatic process. A case of metastatic transitional cell carcinoma of the urinary bladder involving the area of a recently extracted mandibular third molar is reported.