Capodiferro Saverio, d'Amati Antonio, Barile Giuseppe, Dell'Olio Fabio, Limongelli Luisa, Tempesta Angela, Siciliani Rosaria Arianna, Ingravallo Giuseppe, Mastropasqua Mauro, Colella Giuseppe, Boschetti Ciro Emiliano, Copelli Chiara, Maiorano Eugenio, Favia Gianfranco
Unit of Odontostomatology, Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy.
Unit of Pathological Anatomy, Department of Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", 70124 Bari, Italy.
J Clin Med. 2023 Feb 10;12(4):1429. doi: 10.3390/jcm12041429.
Metastases from lung cancer to the oral cavity and to the head and neck generally are very infrequent and usually manifest in advanced stages of the disease. Even more rarely, they are the first sign of an unknown metastatic disease. Nevertheless, their occurrence always represents a challenging situation both for clinicians, in the management of very unusual lesions, and for pathologists, in the recognition of the primary site. We retrospectively studied 21 cases of metastases to the head and neck from lung cancer (sixteen males and five females, age range 43-80 years; eight cases localized to the gingiva [two of these to the peri-implant gingiva], seven to the sub-mandibular lymph nodes, two to the mandible, three to the tongue, one case to the parotid gland; in eight patients, metastasis was the first clinical manifestation of an occult lung cancer) and proposed a wide immunohistochemical panel for a proper identification of the primary tumor histotype, including CK5/6, CK8/18, CK7, CK20, p40, p63, TTF-1, CDX2, Chromogranin A, Synaptophysin, GATA-3, Estrogen Receptors, PAX8, PSA. Furthermore, we collected data from previously published studies and narratively reviewed the relevant literature.
肺癌转移至口腔及头颈部通常极为罕见，且多在疾病晚期出现。更罕见的是，它们是未知转移性疾病的首发症状。然而，其发生对临床医生处理极不寻常的病变以及病理医生识别原发部位而言，始终是一个具有挑战性的情况。我们回顾性研究了21例肺癌转移至头颈部的病例（16例男性和5例女性，年龄范围43 - 80岁；8例局限于牙龈[其中2例为种植体周围牙龈]，7例至下颌下淋巴结，2例至下颌骨，3例至舌，1例至腮腺；8例患者中，转移是隐匿性肺癌的首发临床表现），并提出了一套广泛的免疫组织化学检测指标，以准确识别原发肿瘤的组织学类型，包括细胞角蛋白5/6、细胞角蛋白8/18、细胞角蛋白7、细胞角蛋白20、p40、p63、甲状腺转录因子-1、尾型同源盒转录因子2、嗜铬粒蛋白A、突触素、GATA结合蛋白3、雌激素受体、配对盒基因8、前列腺特异性抗原。此外，我们收集了既往发表研究的数据，并对相关文献进行了叙述性综述。
