Lung Cancer with Oral Cavity Metastasis: Two Case Reports
Year 2024,
Volume: 8 Issue: 2, 72 - 76, 29.08.2024
Hakan Yülek
,
Gaye Keser
,
Filiz Mediha Namdar Pekiner
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.
References
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Oral Kavite Metastazı Görülen Akciğer Kanseri: İki Olgu Sunumu
Year 2024,
Volume: 8 Issue: 2, 72 - 76, 29.08.2024
Hakan Yülek
,
Gaye Keser
,
Filiz Mediha Namdar Pekiner
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.
References
- 1. Allon I, Pessing A, Kaplan I, Allon DM, Hirshberg A. Metastatic tumors to the gingiva and the presence of teeth as a contributing factor: a literature analysis. J. Periodontol. 2014;85(1):132-9.
- 2. Bade BC, Dela Cruz CS. Lung Cancer 2020: Epidemiology, Etiology, and Prevention. Clin. Chest. Med. 2020;41(1):1-24.
- 3. Bodner L, Sion-Vardy N, Geffen DB, Nash M. Metastatic tumors to the jaws: a report of eight new cases. Med. Oral Patol. Oral Cir. Bucal. 2006;11(2):e132-5.
- 4. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA. Cancer J. Clin. 2018;68(6):394-424.
- 5. Curien R, Moizan H, Gerard E. Gingival metastasis of a bronchogenic adenocarcinoma: report of a case. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 2007;104(6):e25-8.
- 6. D'Silva NJ, Summerlin DJ, Cordell KG, Abdelsayed RA, Tomich CE, Hanks CT, Fear D, Meyrowitz S. Metastatic tumors in the jaws: a retrospective study of 114 cases. J. Am. Dent. Assoc. 2006;137(12):1667-72.
- 7. Gupta S, Jawanda MK, Kedia NB, Deb AR, Ganganna A, Saurabh K, Yadav SK, Yadav AB. Lung cancer metastasis to oral soft tissues; Systematic review of 122 cases. J. Clin. Exp. Dent. 2022;14(10):e854-e874.
- 8. Hirshberg A, Berger R, Allon I, Kaplan I. Metastatic tumors to the jaws and mouth. Head Neck Pathol. 2014;8(4):463-74.
- 9.Hirshberg A, Shnaiderman-Shapiro A, Kaplan I, Berger R. Metastatic tumours to the oral cavity- pathogenesis and analysis of 673 cases. Oral Oncol. 2008;44(8):743-52.
- 10. Ito H, Onizawa K, Satoh H. Non-small-cell lung cancer metastasis to the oral cavity: A case report. Mol. Clin. Oncol. 2017;6(3):422-424.
- 11. Kaplan I, Raiser V, Shuster A, Shlomi B, Rosenfeld E, Greenberg A, Hirshberg A, Yahalom R, Shnaiderman-Shapiro A, Vered M. Metastatic tumors in oral mucosa and jawbones: Unusual primary origins and unusual oral locations. Acta. Histochem. 2019;121(8):151448.
- 12. Khalili M, Mahboobi N, Shams J. Metastatic breast carcinoma initially diagnosed as pulpal/periapical disease: a case report. J. Endod. 2010;36(5):922-5.
- 13. Kirschnick LB, Schuch LF, Cademartori MG, Vasconcelos ACU. Metastasis to the oral and maxillofacial region: A systematic review. Oral. Dis. 2022;28(1):23-32.
- 14. Kumar G, Manjunatha B. Metastatic tumors to the jaws and oral cavity. J. Oral Maxillofac. Pathol. 2013;17(1):71-5.
- 15. Kumar V, Abbas AK, Aster JC, Fausto N. Robbins and Cotran Pathologic Basis of Disease. Philadelphia: Saunders; 2010.
- 16. Lopes AM, Freitas F, Vilares M, Caramês J. Metastasis of malignant tumors to the oral cavity: Systematic review of case reports and case series. J. Stomatol. Oral Maxillofac. Surg. 2023;124(1S):101330.
- 17. Nasim F, Sabath BF, Eapen GA. Lung Cancer. Med Clin North Am. 2019;103(3):463-473.
- 18. Özbayrak S. Ağız Hastalıkları Atlası: Quintessence;2020.
- 19. Pekiner FN, Özbayrak S. Ağız Kanserleri -Erken Tanı Bakımından Diş Hekimliği. İstanbul: Quintessence;2016.
- 20. Pires FR, Sagarra R, Corrêa ME, Pereira CM, Vargas PA, Lopes MA. Oral metastasis of a hepatocellular carcinoma. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 2004;97(3):359-68.
- 21. Poulias E, Melakopoulos I, Tosios K. Metastatic breast carcinoma in the mandible presenting as a periodontal abscess: a case report. J. Med. Case Rep. 2011(1);5:265.
- 22. Rao RS, Patil S, Sanketh D, Amrutha N. Metastatic tumors of the oral cavity. J. Contemp. Dent. Pract. 2014;15(2):263-71.
- 23. Schabath MB, Cote ML. Cancer Progress and Priorities: Lung Cancer. Cancer Epidemiol. Biomarkers Prev. 2019;28(10):1563-1579.
- 24. Shen ML, Kang J, Wen YL, Ying WM, Yi J, Hua CG, Tang XF, Wen YM. Metastatic tumors to the oral and maxillofacial region: a retrospective study of 19 cases in West China and review of the Chinese and English literature. J. Oral. Maxillofac. Surg. 2009;67(4):718-37.
- 25. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA. Cancer J. Clin. 2021;71(3):209-249.
- 26. Tatlidil R, Gözübüyük MM. Mucinous adenocarcinoma of lung presenting as oral metastases: a case report and literature review. J. Endod. 2011;37(1):110-3.
- 27. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA. Cancer J. Clin. 2015;65(2):87-108.
- 28. Torre LA, Siegel RL, Jemal A. Lung Cancer Statistics. Adv Exp Med Biol. 2016;893:1-19.
- 29. Yin JJ, Pollock CB, Kelly K. Mechanisms of cancer metastasis to the bone. Cell Res. 2005;15(1):57-62.