Rashid Nouman, Bansal Adity, Chug Ashi
Department of Dentistry (Cranio-Maxillofacial Surgery), AIIMS, Rishikesh, Uttarakhand, India.
Contemp Clin Dent. 2021 Jan-Mar;12(1):99-101. doi: 10.4103/ccd.ccd_217_20. Epub 2021 Mar 20.
Intestinal-type adenocarcinoma is an aggressive malignancy with the rare possibility of metastatic spread to the mandible. We represent a case of a 30-year-old female patient who reported with a chief complaint of a right mandibular mass for 4 months. Orthopantomogram X-ray observed an ill-defined lytic lesion with severe periosteal reaction. Incisional biopsy revealed "colonic variant of intestinal-type adenocarcinoma." Expression of cytokeratin 20 and caudal type homeobox transcription factor 2 (CDX-2) markers was seen on immunohistochemistry. Biochemical markers such as serum cancer antigen 125, serum alkaline phosphatase, and serum carcinoembryonic antigen were raised. Contrast-enhanced computed tomography of the thorax and abdomen suggested cavitary lesions in the bilateral lungs, right adrenal gland, and mediastinum. Positron emission tomography revealed multiple lesions in the body, hence confirming the diagnosis. The patient was kept on palliative chemotherapy. It is concluded that prompt diagnosis and initiation of treatment increases the chances of survival in such cases.
肠型腺癌是一种侵袭性恶性肿瘤，极少发生转移至下颌骨的情况。我们报告了一例30岁女性患者，其主要诉求为右下颌肿物4个月。全景曲面断层X线片观察到一个边界不清的溶骨性病变，并伴有严重的骨膜反应。切开活检显示为“肠型腺癌的结肠变异型”。免疫组化可见细胞角蛋白20和尾型同源框转录因子2（CDX-2）标志物表达。血清癌抗原125、血清碱性磷酸酶和血清癌胚抗原等生化标志物升高。胸部和腹部增强计算机断层扫描提示双侧肺、右肾上腺和纵隔有空洞性病变。正电子发射断层扫描显示体内有多处病变，从而确诊。该患者接受了姑息化疗。结论是，在此类病例中，及时诊断和开始治疗可增加生存机会。
