Okada H, Kamino Y, Shimo M, Kitamura E, Katoh T, Nishimura H, Akimoto Y, Kaneda T, Hinata M, Yamamoto H
Department of Pathology, Nihon University School of Dentistry at Matsudo, Chiba, Japan.
Int J Oral Maxillofac Surg. 2003 Feb;32(1):97-100. doi: 10.1054/ijom.2002.0242.
A rare case of metastatic hepatocellular carcinoma (HCC) of the maxillary sinus in a 67-year-old man is reported along with the findings at autopsy. A fine needle aspiration biopsy specimen revealed a characteristic tumour structure resembling primary HCC. At autopsy, metastatic lesions were recognized in the bilateral adrenals, spleen, sternum, vertebrae and lymph node at the lesser curvature of the stomach, but not in the lung, suggesting that the HCC had metastasized to the maxillary sinus via the plexus venous vertebralis and/or the azygos vein, or lymph duct. In our reviewed 29 cases of metastatic HCC in the oro-maxillofacial region, most patients were men in the 50- to 70-year age range. At least 11 cases did not have lung metastasis, and in 18, metastasis to the oro-maxillofacial region was the first sign of HCC. One should be aware of the possibility to encounter the oral lesion as first sign of metastatic HCC.
本文报告了一例67岁男性上颌窦转移性肝细胞癌（HCC）的罕见病例，并展示了尸检结果。细针穿刺活检标本显示出类似原发性HCC的特征性肿瘤结构。尸检时，在双侧肾上腺、脾脏、胸骨、椎骨以及胃小弯处的淋巴结发现了转移病灶，但肺部未发现，这表明HCC可能通过椎静脉丛和/或奇静脉或淋巴管转移至上颌窦。在我们回顾的29例口腔颌面部转移性HCC病例中，大多数患者为50至70岁的男性。至少11例没有肺转移，18例中，转移至口腔颌面部区域是HCC的首发症状。应意识到将口腔病变作为转移性HCC首发症状的可能性。
