Cristofaro Maria Giulia, Giudice Amerigo, Colangeli Walter, Giudice Mario
Unit of Maxillo-Facial Surgery, University Magna Graecia", Catanzaro, Italy.
Ann Ital Chir. 2011 Jul-Aug;82(4):289-96.
The aim of our study is to describe the rare location of metastasis cancers (kidney and prostate) in the jaw bones (maxillary branch and the condyle); this is the first and the only sign of disease.
Two patients referred to us for a swelling in his left preauricolar region with a moderate pain. They underwent a radiologic and bioptic examinations that showed a metastasis which could arise from a primary prostatic and renal adenocarcinoma. The patients underwent surgical treatment (Subtotal-emimandibulectomy and reconstruction with metallic endoprosthesis).
The final follow up for the first patient was acceptable and without any motor or sensory deficit. The patient also underwent chemotherapy for his primary tumour and radiotherapy of his mandibular condyle metastasis during the preoperative stage. The final follow-up of the second patient was performer two years after the surgery and it did not show any recurrence and after about 18 months from surgery has performed dentistry rehabilitation. The patient had a chemotherapy treatment with the administration of bisphosphonates for the presence of skeletal metastases.
Just 1% of carcinomas metastasizes in jaw bones. The low rate is linked to the low active bone marrow content in jaw bones of adult patients. For the prostatic and breast adenocarcinomas the neoplastic embolis reaches the skeleton directly, passing through the vertebral venous system (Batson's hypothesis). Early diagnosis made the treatment both of the primary tumour and of its recurrence (single metastasis) more effective.
我们研究的目的是描述转移癌（肾和前列腺）在颌骨（上颌支和髁突）的罕见位置；这是疾病的首个也是唯一迹象。
两名患者因左侧耳前区肿胀伴中度疼痛前来就诊。他们接受了放射学和活检检查，结果显示为可能源自原发性前列腺腺癌和肾腺癌的转移瘤。患者接受了手术治疗（下颌骨次全切除术并用金属假体进行重建）。
第一名患者的最终随访情况尚可，无任何运动或感觉功能障碍。该患者在术前阶段还接受了针对其原发性肿瘤的化疗以及下颌髁突转移瘤的放疗。第二名患者在手术后两年进行了最终随访，未显示任何复发情况，且在手术后约18个月进行了牙科修复。由于存在骨转移，该患者接受了双膦酸盐化疗。
仅有1%的癌症会转移至颌骨。这一低发生率与成年患者颌骨中低活性骨髓含量有关。对于前列腺癌和乳腺癌，肿瘤栓子直接通过椎静脉系统到达骨骼（巴特森假说）。早期诊断使原发性肿瘤及其复发（单个转移瘤）的治疗更为有效。
