Zandi Mohammad, Jafari Mohammad, Isapour Mona, Jafari Amir Abbas
Department of Oral and Maxillofacial Surgery, Hamedan University of Medical Sciences, Hamedan, Iran.
Department of Pathology, Hamedan University of Medical Sciences, Hamedan, Iran.
J Oral Maxillofac Pathol. 2014 Sep-Dec;18(3):449-52. doi: 10.4103/0973-029X.151347.
Mandibular metastasis as the first manifestation of undiscovered synchronous double primary cancers is extremely rare, so, it is presented in the current study.
This study reports a 73-year-old man, complaining of a painful mass in the mandible. After history taking, physical examination and panoramic radiographic evaluation; an incisional biopsy was performed intraorally. Histological studies revealed a metastatic tumor of epithelial origin with nonspecific primary site. During metastatic workup of the patient, it was accidentally found that three organs including prostate, lung and thyroid were involved with cancer. Using immunohistochemical study (prostate-specific antigen (PSA), thyroid transcription factor 1 (TTF-1) and thyroglobulin), a final diagnosis of thyroid carcinoma metastasis to the mandible was established.
This case report showed that the practitioners should always maintain a high index of suspicion to the possibility that a patient with an orofacial metastatic lesion may have two or more synchronous primary cancers.
下颌骨转移作为未发现的同步双原发癌的首发表现极为罕见，因此，在本研究中予以呈现。
本研究报告了一名73岁男性，主诉下颌骨有疼痛性肿块。在进行病史采集、体格检查和全景放射影像学评估后；在口腔内进行了切开活检。组织学研究显示为起源于上皮的转移性肿瘤，原发部位不明确。在对该患者进行转移灶检查时，意外发现前列腺、肺和甲状腺三个器官均有癌症累及。通过免疫组织化学研究（前列腺特异性抗原（PSA）、甲状腺转录因子1（TTF-1）和甲状腺球蛋白），最终确诊为甲状腺癌转移至下颌骨。
本病例报告表明，从业者应始终高度怀疑口面部转移病变患者可能患有两种或更多种同步原发癌。
