Adewale Adesina O, Mofoluwake Ladeji A, Olamide Opaleye T, Yussuf Salami A
Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Lagos State University College of Medicine, Lagos State, Nigeria.
Department of Oral Pathology, Faculty of Dentistry, Lagos State University College of Medicine, Lagos State, Nigeria.
Ghana Med J. 2018 Sep;52(3):168-172. doi: 10.4314/gmj.v52i3.11.
Metastatic tumours of the oral cavity are not common. The most common site for bone metastases in the head and neck region is the mandible. Metastatic lesion of the mandible most commonly originate from the lungs in men and breast in women, and these lesions (or tumours) usually are carcinomas rather than sarcomas. We report two cases of metastatic lesions in the mandible: (1) A 19year old male with right mandibular swelling and a nodular swelling in the distal two-third of the right tibia. Radiograghs revealed sclerotic lesion with a sunburst appearance in both the jaw and tibia. Histology of the jaw lesion confirmed a metastatic osteosarcoma of the mandible. (2) A 51year old female with a right mandibular swelling with associated swelling in the anterior neck, right shoulder and right parietal region of the skull. Computerised tomography scan (CT) of the jaws showed an osteolytic lesion of the right mandible. CT scan of the brain also showed a large lytic lesion seen in the posterior aspect of the right parietal bone. Histology of the jaw mass confirmed a metastatic follicular carcinoma from the thyroid. Mandibular metastasis may be the first presenting feature of underlying occult malignancy of another primary site. Therefore, clinicians should maintain a high level of suspicion while evaluating patients with a history of cancer presenting with oral lesions.
口腔转移性肿瘤并不常见。头颈部骨转移最常见的部位是下颌骨。下颌骨转移性病变在男性中最常起源于肺部,在女性中最常起源于乳腺,并且这些病变(或肿瘤)通常是癌而非肉瘤。我们报告两例下颌骨转移性病变:(1)一名19岁男性,右下颌肿胀,右胫骨远端三分之二处有结节状肿胀。X线片显示颌骨和胫骨均有呈日光放射状外观的硬化性病变。颌骨病变的组织学检查证实为下颌骨转移性骨肉瘤。(2)一名51岁女性,右下颌肿胀,伴有颈部前方、右肩部和颅骨右顶叶区域肿胀。颌骨计算机断层扫描(CT)显示右下颌骨有溶骨性病变。脑部CT扫描还显示右顶骨后部有一个大的溶骨性病变。颌骨肿物的组织学检查证实为来自甲状腺的转移性滤泡癌。下颌骨转移可能是另一原发部位潜在隐匿性恶性肿瘤的首发表现。因此,临床医生在评估有癌症病史且出现口腔病变的患者时应保持高度怀疑。