Lung Cancer with Oral Cavity Metastasis: Two Case Reports

Abstract

Invasion and metastasis, which are important biological hallmarks of malignant tumors, are among the most important causes of cancer-related morbidity and mortality. Metastatic tumors in the oral cavity constitute 1-1.5% of oral malignant tumors and the most common primary foci metastasizing to this region are breast, lung, kidney, bone, prostate and colon cancers. The most common site of involvement in the jaw bones is the mandible posterior, while soft tissue involvement is most common in the gingiva. A 63-year-old male patient presented with a mass invading the alveolar bone with irregular and ulcerated areas after extraction of mandibular anterior teeth. Incisional biopsy was performed and histopathological examination of the mass revealed a diagnosis of carcinoma predominantly composed of clear cells. He was referred to the oncology service for investigation of the primary focus and lung cancer was diagnosed by PET-CT scan. A 62-year-old male patient who was diagnosed with lung cancer one year ago and had long bone metastases in his anamnesis presented with pain in the left mandible, which was thought to be caused by the residual tooth root. CBCT examination revealed moth-eaten osteolytic areas in the cortical and trabecular structure involving the inferior alveolar canal in the ramus region of the left mandible. The patient with lung cancer and distant organ metastases was referred to the oncology department and palliative treatment was continued. Both patients died after 3 and 6 months of follow-up. The presence of metastases indicates a poor prognosis and various treatments can be applied according to the stages. Changes occurring in the oral cavity should be followed carefully and diagnosis should be made by histopathological examination when necessary.

Keywords

• Oral cavity
• oral cancer
• lung cancer
• histopathology
• metastates

Oral Kavite Metastazı Görülen Akciğer Kanseri: İki Olgu Sunumu

Abstract

Malign tümörlerin önemli biyolojik ayırt edici özelliklerinden olan invazyon ve metastaz; kansere bağlı morbidite ve mortalitenin en önemli nedenlerindendir. Oral kavite de görülen metastatik tümörler oral malign karakterli tümörlerin %1-1.5’ ini oluşturmaktadır ve bu bölgeye metastaz yapan en yaygın primer odaklar arasında meme, akciğer, böbrek, kemik, prostat ve kolon kanserleri gelmektedir. Çene kemiklerinde en sık tutulum alanı mandibula posterior iken yumuşak doku tutulumları en sık dişetine olmaktadır. 63 yaşında erkek hasta mandibula anterior dişlerin çekimi sonrası gelişen, alveol kemiğe invaze, yüzeyi düzensiz ve ülsere alanlar içeren kitle şikayetiyle başvurmuştur. İnsizyonel biyopsi ile değerlendirilen kitlenin histopatolojik incelemesinde saydam hücrelerden baskın karsinom tanısı almıştır. Primer odağın araştırılması için onkoloji servisine yönlendirilmiş ve PET-CT taraması ile akciğer kanseri teşhisi koyulmuştur. Anamnezinde bir yıl önce akciğer kanseri teşhisi koyulan ve uzun kemik metastazları bulunan 62 yaş erkek hasta sol mandibulada rezidüel diş kökünden kaynaklandığını düşündüğü ağrı şikayetiyle başvurmuştur. Yapılan CBCT incelemesinde sol mandibula ramus bölgesinde inferior alveolar kanalı içine almış, kortikal ve trabekül yapıda güve yeniği tarzında osteolitik alanlar izlenmiştir. Akciğer kanseri ve uzak organ metastazları bulunan hasta onkoloji bölümüne yönlendirilmiş ve palyatif tedavisine devam etmiştir. Her iki hasta da 3 ve 6 ay takip sonunda yaşamını yitirmiştir. Metastazların varlığı kötü prognoza işaret eder ve evrelere göre çeşitli tedaviler uygulanabilir. Oral kavite de meydana gelen değişimler dikkatle takip edilmeli, gerekli durumlarda histopatolojik inceleme ile tanıya gidilmelidir.

Keywords

• Oral kavite
• oral kanser
• akciğer kanseri
• histopatoloji
• metastaz

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