Kaufmann M G, Perren A, Grätz K W, Eyrich G K H
Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, UniversitätsSpital Zürich.
Mund Kiefer Gesichtschir. 2005 Sep;9(5):336-40. doi: 10.1007/s10006-005-0623-7.
Metastases in the mandibular condyle are rare. A survey of the literature showed that only 23 of 69 selected cases qualified under the criteria of Meyer and Shklar.
A 48-year-old white male suffering from a previously operated lung carcinoma was referred due to pain and discomfort in the left TMJ. A solitary condylar metastasis of the mandible was revealed. Because of diffuse tumorous infiltration into periarticular tissue, irradiation treatment was performed. During the long-term follow-up growth of additional skeletal metastases occurred.
The course of condylar metastases in general is similar to other metastases involving the jaw. Breast cancer as the primary tumor is most frequent, followed by lung cancer. There are no specific clinical or radiological parameters leading to diagnosis. The clinician should take a potential metastasis into account when dealing with TMJ complaints, radiological oddities, and medical history of malignant tumors. For proper treatment planning, diagnosis should be based on histology. Since the diagnosis of metastasis is usually made at an advanced stage of disease, therapy will be mainly intended as palliative.
下颌骨髁突转移瘤较为罕见。文献调查显示，在69例入选病例中，仅有23例符合迈耶和施克莱尔的标准。
一名48岁的白人男性，曾接受过肺癌手术，因左侧颞下颌关节疼痛和不适前来就诊。检查发现下颌骨有一处孤立的髁突转移瘤。由于肿瘤已扩散至关节周围组织，遂进行了放射治疗。在长期随访过程中，出现了其他骨骼转移瘤。
髁突转移瘤的病程一般与累及颌骨的其他转移瘤相似。以乳腺癌作为原发肿瘤最为常见，其次是肺癌。目前尚无导致诊断的特异性临床或放射学参数。临床医生在处理颞下颌关节主诉、放射学异常以及恶性肿瘤病史时，应考虑到潜在的转移瘤。为了制定恰当的治疗方案，诊断应基于组织学检查。由于转移瘤的诊断通常在疾病晚期做出，治疗将主要以姑息治疗为主。
