Atarbashi-Moghadam Saede, Jafarian Mohammad, Dowdani Shaghayegh
Dept. of Oral and Maxillofacial Pathology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Dept. of Oral and Maxillofacial Surgery, Taleghani Medical Center, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Dent (Shiraz). 2023 Dec 1;24(4):444-448. doi: 10.30476/dentjods.2023.97749.2034. eCollection 2023 Dec.
Metastatic lesions of the jaws are a diagnostic challenge because of their scarcity and uncharacteristic clinical-radiographic features. Carcinoma of unknown primary origin (CUP) is characterized by the existence of metastatic disease with no recognized primary neoplasm after a comprehensive work-up. CUP shows a poor prognosis with limited treatment choices. This paper presents a 64-year-old male with a chief complaint of paresthesia of the chin and lower lip. Panoramic radiography showed an ill-defined radiolucency in the left mandibular molar area and the residue of the first molar root. Microscopic examination demonstrated features of mucin-producing adenocarcinoma and was not similar to common neoplasms of the jaw. The whole-body scan revealed multiple osseous uptakes. CDX2 was diffusely positive. However, in the end, the origin of the primary tumor was not determined. Considering the aforementioned data, the diagnosis of metastatic adenocarcinoma with unknown primary origin was made. CUP of the oral cavity is an extremely rare event. The possibility of metastasis should be raised in a patient who complains of paresthesia. Awareness of the clinical and histopathologic features of these malignancies is crucial for clinicians and pathologists to have a proper diagnosis.
颌骨转移性病变由于其罕见性以及不典型的临床影像学特征，是一项诊断难题。原发灶不明的癌（CUP）的特点是在全面检查后存在转移性疾病但未发现公认的原发性肿瘤。CUP预后较差，治疗选择有限。本文介绍了一名64岁男性，主诉为下巴和下唇感觉异常。全景X线片显示左下颌磨牙区有边界不清的透射区以及第一磨牙牙根残端。显微镜检查显示为产生黏液的腺癌特征，与常见的颌骨肿瘤不同。全身扫描显示多处骨摄取。CDX2弥漫性阳性。然而，最终原发性肿瘤的起源仍未确定。考虑到上述数据，诊断为原发灶不明的转移性腺癌。口腔CUP极为罕见。对于主诉感觉异常的患者，应提高转移的可能性。了解这些恶性肿瘤的临床和组织病理学特征对于临床医生和病理学家进行正确诊断至关重要。
