Papa F, Ferrara S, Felicetta L, Lavorgna G, Matarazzo M, Staibano S, De Rosa G, Troisi S, Claudio P P
Department of Odontostomatologic and Maxillofacial Sciences, University of Naples Federico II, Napoli, Italy.
Anticancer Res. 2001 May-Jun;21(3C):2121-30.
Hepatocellular carcinoma (HCC) is a malignant tumor with a marked tendency to spread through the portal system. Metastases from HCC usually involve lungs, surrenal glands, the skeletal and gastroenteric systems, spleen, heart and kidneys. Secondary localizations to the mandible are rare. Generally, bone metastases from HCC appear as osteolytic lesions more likely localized to the ribs, spine, femor, omer, sternum, and then to the mandible. Mandibular metastatic HCC is hemorrhagic in nature because of its hypervascularity. Any diagnostic maneuver that could end in bleeding should be avoided. Non-invasive diagnostic procedures such as computer tomography (CT) scan should be preferred. Among the invasive diagnostic procedures, only fine needle biopsy should be attempted and palliative radiotherapy could be useful for the control of local symptoms. A case report of a hemorrhagic mandibular metastatic HCC that had to be treated surgically, in order to control the severe and profuse bleeding, is presented.
肝细胞癌（HCC）是一种具有明显通过门静脉系统扩散倾向的恶性肿瘤。HCC的转移通常累及肺、肾上腺、骨骼和胃肠系统、脾脏、心脏和肾脏。下颌骨的继发性定位很少见。一般来说，HCC的骨转移表现为溶骨性病变，更可能定位于肋骨、脊柱、股骨、肱骨、胸骨，然后是下颌骨。下颌骨转移性HCC本质上是出血性的，因为其血管丰富。应避免任何可能导致出血的诊断操作。应首选计算机断层扫描（CT）等非侵入性诊断程序。在侵入性诊断程序中，仅应尝试细针活检，姑息性放疗可能有助于控制局部症状。本文报告了一例出血性下颌骨转移性HCC病例，为控制严重的大出血，不得不进行手术治疗。
