Steffen Claudius, Doll Christian, Thieme Nadine, Waluga Richard, Beck-Broichsitter Benedicta
Department of Oral and Maxillofacial Surgery, Charité - University Medicine Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany.
Department of Oral and Maxillofacial Surgery, Charité - University Medicine Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany.
Int J Surg Case Rep. 2020;70:53-55. doi: 10.1016/j.ijscr.2020.04.044. Epub 2020 May 11.
Oral metastatic tumors due to malignancies at distant locations are very rare. There are only few cases in the literature reporting about mandible/cervical metastases. Sometimes the oral finding is the manifestation of the disease.
We report on a 50-year-old patient who was diagnosed with a pathological mandibular fracture and cervical lymph node metastases due to an adenocarcinoma of the lung without other peripheral metastases. Following the interdisciplinary tumor board decision, resection and ipsilateral neck dissection including a mandible reconstruction using a microvascular fibula transplant was performed. The patient received an adjuvant chemotherapy with carboplatin/pemetrexed.
The combination of cervical metastases and a pathological mandibular fracture has not been reported before. Distinction between oligometastatic and polymetastatic disease may be difficult. Bone lesions and a high number of metastases are associated with a negative outcome. In cases of limited oligometastatic diseases, metastasectomy might sometimes be indicated. Due to the absence of other peripheral metastases decision of metastasectomy was made.
Due to rare occurrence of cervical metastases special attention should be paid to the incidence of possible metastases of distant malignancies at uncommon regions.
由远处恶性肿瘤引起的口腔转移性肿瘤非常罕见。文献中仅有少数关于下颌骨/颈部转移的病例报道。有时口腔表现是该疾病的首发症状。
我们报告一例50岁患者,诊断为因肺腺癌导致的病理性下颌骨骨折和颈部淋巴结转移,无其他远处转移。经多学科肿瘤委员会讨论决定,进行切除及同侧颈部清扫术,包括使用微血管腓骨移植进行下颌骨重建。患者接受了卡铂/培美曲塞辅助化疗。
此前尚未有颈部转移合并病理性下颌骨骨折的报道。区分寡转移和多转移疾病可能存在困难。骨病变和大量转移与不良预后相关。在寡转移疾病局限的情况下,有时可能需要进行转移灶切除术。由于无其他远处转移,故决定行转移灶切除术。
由于颈部转移罕见,应特别关注远处恶性肿瘤在不常见部位发生转移的可能性。