Department of Oral and Maxillofacial Surgery, Ehime University Graduate School of Medicine.
Int J Oral Maxillofac Surg. 2010 Mar;39(3):301-4. doi: 10.1016/j.ijom.2009.10.014. Epub 2009 Nov 25.
Metastasis of malignant tumors to the oral cavity is rare. The authors report a case of thyroid carcinoma with mandibular osteoblastic metastasis. An 83-year-old female presented with lower jaw swelling and pain. An elastic hard subcutaneous mass was observed in the median mandible. X-ray images confirmed a tumor lesion with periosteal reaction spreading radially from the mandible. A biopsy revealed nests of large, polygonal tumor cells growing in a supporting fibrovascular framework. The patient's anamnesis included thyroid carcinoma with lung metastasis, 2 years ago, treated by total enucleation of the thyroid and excision of the superior lobe of the left lung. Biopsy, primary and metastatic tumor samples all tested positive for thyroglobulin, suggesting a thyroid follicular epithelial origin. Mandibular metastasis of poorly differentiated carcinoma of the thyroid gland was diagnosed. Consent for further treatment was not obtained. The patient died 1 year and 7 months later.
恶性肿瘤转移至口腔较为罕见。本文报道了 1 例甲状腺癌下颌骨成骨转移病例。1 名 83 岁女性因下颌肿胀和疼痛就诊。于下颌正中可触及一弹性硬的皮下肿块,X 线片显示肿瘤病变伴骨膜反应,呈放射状自下颌骨向周围扩散。活检显示大而多边形的肿瘤细胞巢,生长在支持性纤维血管基质中。患者既往有甲状腺癌伴肺转移病史,2 年前行甲状腺全切除术和左肺上叶切除术。活检、原发和转移肿瘤样本均对甲状腺球蛋白呈阳性,提示甲状腺滤泡上皮来源。诊断为甲状腺未分化癌下颌骨转移。由于未获得进一步治疗的同意,患者 1 年 7 个月后死亡。