Zachariades N
Oral and Maxillofacial Clinic, General Peripheral Hospital of Attica, Kifissia, Athens, Greece.
J Craniomaxillofac Surg. 1989 Aug;17(6):283-90. doi: 10.1016/s1010-5182(89)80098-8.
5% of all malignancies involve the oral cavity. One percent of these malignancies are secondary to neoplasms that are usually found below the level of the clavicles. As it is widely accepted that the jaws do not contain a lymphatic system, it is believed that metastases there occur via the blood stream, a fact that is supported by the occurrence of metastatic foci in areas where spongiosa and slowing of the circulation favour the entrapment of metastatic emboli. This however does not explain why most of the metastases occur in the lower jaw (and in particular in the premolar-molar area) and not in the maxilla, where the spongiosa is more abundant. Batson's plexus has also been mentioned as a possible route of metastasis to the head and neck, thus explaining why, in some cases of metastases, the lungs are not involved, as the blood has not been filtered through the pulmonary bed before reaching the head and neck. In our review of the literature we found 422 metastatic lesions in the mouth, jaws and the surrounding tissues in 365 patients equally divided between men and women. 56.5% of the cases were above the age of 50. In 228 cases there were other metastases as well, whereas in 114 cases the only metastasis found was the one under study. In 22% of the cases, the metastatic focus in our area was the first indication of the existence of an undiagnosed primary malignant tumour somewhere else.(ABSTRACT TRUNCATED AT 250 WORDS)
所有恶性肿瘤中有5%累及口腔。其中1%的恶性肿瘤继发于通常位于锁骨水平以下的肿瘤。由于人们普遍认为颌骨不含淋巴系统，所以认为那里的转移是通过血流发生的，松质骨区域和血液循环减缓有利于转移性栓子滞留的区域出现转移灶这一事实支持了这一点。然而，这并不能解释为什么大多数转移发生在下颌（尤其是前磨牙-磨牙区）而不是上颌，上颌的松质骨更丰富。巴特森静脉丛也被提及为转移至头颈部的可能途径，从而解释了为什么在某些转移病例中肺部未受累，因为血液在到达头颈部之前未经过肺循环过滤。在我们对文献的回顾中，我们发现365例患者（男女各半）的口腔、颌骨及周围组织中有422个转移病灶。56.5%的病例年龄在50岁以上。228例病例还存在其他转移，而114例病例中仅发现了正在研究的这一转移灶。在22%的病例中，我们所在区域的转移灶是其他部位未确诊原发性恶性肿瘤存在的首个迹象。（摘要截选至250词）
