Oral metastasis of alveolar soft-part sarcoma: a case report and review of literature

Alveolar soft-part sarcoma of the oral cavity: A review of literature

An alveolar soft-part sarcoma is a malignant neoplasm primarily affecting the soft tissues of head and neck. The aim of the present review is to systematically present the demographic and clinico-pathological data of articles published in the English medical literature. A comprehensive search of the databases (PubMed, Medline, SCOPUS, Web of Science, and Google Scholar) along with cross references to the published articles on alveolar soft-part sarcoma for eligible studies/case reports published since 1957 till date was done to retrieve the data. A total of 74 cases were identified and analyzed from 42 papers published in the English medical literature. All the clinical, radiographic, and prognostic features were analyzed and presented along with the treatment strategies. Alveolar soft-part sarcoma is a rare and aggressive malignancy of uncertain histologic origin with a propensity for vascular invasion and distant metastasis. This neoplasm requires careful clinical, radiographic, and histopathologic evaluation to reach to the correct diagnosis.

Alveolar soft part sarcoma metastatic to the mandible: A report and review of literature

Alveolar soft part sarcoma (ASPS) is a rare neoplasm constituting less than 1% of all soft tissue sarcomas. It tends to occur in the deep soft tissues of the lower extremities, however approximately 5-12% of cases are primary to the head and neck region. ASPS metastatic to the oral cavity is rare, with only four documented cases in the literature. Here, we present the case of a 29-year-old woman with ASPS metastatic to the mandible. To the best of our knowledge, this represents only the 5th documented case of ASPS metastatic to the oral cavity, and more specifically, the 3rd documented case of mandibular metastasis.

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.

Metastasis to the oral soft tissues: A review of 412 cases

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.

Alveolar soft-part sarcoma of the masseter and mandibular ramus: Report of a case and review of the literature

Alveolar soft-part sarcomas are clinically and morphologically distinct soft-tissue sarcomas, with an unknown histogenesis. When the tumors affect the region of the head and neck, they are often located in the orbit and tongue. We report a case of an alveolar soft-part sarcoma in the left masseter of a 28-year-old female. The patient had chronic pain and paresthesia of her left lower lip. Panoramic radiography and computed tomography showed a well-delimited radiolucent mass in the left ramus. An incisional biopsy was performed, and the sample submitted for histopathological study. The tumor showed positive periodic acid-Schiff diastase-resistant granules. Immunohistochemically, the tumor cells were diffusely positive for myoglobin, and focally positive for actin and desmin.

Metastatic carcinomas to the oral cavity and oropharynx

Background

Metastases to the oral/oropharynx are very rare and their diagnosis is challenging.

Methods

We reviewed pathologic data for malignant tumors of the oral/oropharynx that were diagnosed at the Asan Medical Center, Seoul, Korea from 1995 until 2010.

Results

Twenty-nine cases of oral/oropharyngeal metastases were retrieved, comprising 2.0% of 1,445 malignancies. The most common primary sites were the liver and lung, followed by the stomach, colon, breast, prostate, and kidney. The gingiva was the most common metastatic site, followed by the tonsil/pillar, mandible, tongue, tongue base, palate mucosa, mouth floor, and buccal mucosa. Intervals between detection of primary tumors and metastases were variable, from -1 month to 104 months. Ten patients with lung (7 cases), liver, stomach, and kidney carcinomas manifested with oral/oropharyngeal metastases as the first sign of systemic metastases. The majority of patients had died within one year of the onset of an oral/oropharyngeal metastasis, but exceptionally long-lived cases were also present. The survival periods of patients with lung cancers were longer than those of patients with non-pulmonary tumors.

Conclusions

An awareness of the incidence, common primary sites, metastatic subsites, and metastatic courses or patterns of oral/oropharyngeal metastases is helpful in the diagnosis of metastatic carcinomas.