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下颌骨转移性乳腺癌:一例具有诊断挑战性的罕见病例报告

Mandibular Metastatic Breast Cancer: A Rare Case Report with Diagnostic Challenge.

作者信息

Mehdizadeh Mohammad, Lotfi Ali, Atarbashi-Moghadam Saede, Eftekhari Moghadam Parsa

机构信息

Dept. of Oral and Maxillofacial Surgery, School of Dentistry, Qom University of Medical Sciences, Qom, Iran.

Dept. of Oral and Maxillofacial Pathology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

J Dent (Shiraz). 2025 Sep 1;26(3):284-287. doi: 10.30476/dentjods.2025.103764.2475. eCollection 2025 Sep.

Abstract

Jawbone metastatic lesions are a diagnostic challenge because of their rarity and variable clinical, radiographic, and histopathologic characteristics. This paper presents a 57-year-old female with a chief complaint of lower face swelling. Cone beam computed tomography (CBCT) showed a multilocular radiolucency with right angle septa in the left mandibular area with cortical destruction. She had a history of right breast cancer about six years ago. Histopathologic examination revealed sheets of malignant small round cells. Immunohistochemistry (IHC) was only positive for cytokeratin (CK) and GATA3. CA15-3 tumor marker was higher than the normal range. Based on the aforementioned data, the diagnosis of metastatic breast carcinoma was performed. The whole-body and computed tomography (CT) scan showed just involvement in the left mandibular area. The radiographic appearance of metastatic lesions might be misleading, and microscopic sections might be poorly differentiated, therefore, a precise past medical history, IHC staining, and tumor markers are valuable issues in diagnosing oral cavity metastasis.

摘要

颌骨转移性病变因其罕见以及临床、影像学和组织病理学特征各异,在诊断上具有挑战性。本文介绍了一名57岁女性,主要症状为下脸部肿胀。锥形束计算机断层扫描(CBCT)显示左下颌区域有一个多房性透射区,伴有直角分隔,皮质破坏。她大约六年前有右乳腺癌病史。组织病理学检查显示有片状恶性小圆形细胞。免疫组织化学(IHC)仅细胞角蛋白(CK)和GATA3呈阳性。CA15-3肿瘤标志物高于正常范围。基于上述数据,诊断为转移性乳腺癌。全身计算机断层扫描(CT)显示仅左下颌区域受累。转移性病变的影像学表现可能具有误导性,且显微镜切片可能分化不良,因此,准确的既往病史、IHC染色和肿瘤标志物对于诊断口腔转移瘤很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5d3/12394743/9bdfb5c0f9ad/JDS-26-3-284-g001.jpg

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