Öz
Introduction: Mandibular metastases are quite rare
and they constitute less than about %1 of the mandibular malignancies. In
mandibular metastatic cases, patients’ complaints generally include bony
swelling with pain, tooth pain and tooth loss. Mandibular metastatic lesions
mimic periodontal diseases; therefore careful examination is necessary. In
differential diagnosis, osteosarcoma, which is a primary bone tumor, primary
intraosseous squamous carcinoma, ameloblastoma, and temporomandibular joint
diseases should be taken into consideration. Treatment modalities are surgery
and chemoradiotherapy. Because of the poor prognosis, the goal of the treatment
is only palliative.
Case Report: A 51-year-old woman, operated due to rectal adenocarcinoma 3 years previously,
was referred to our clinic with a complaint of swelling on the jaw. Cranial
magnetic resonance imaging and maxillofacial computed
tomography revealed a mass that extended to condyle and lead to bone
destruction on the right ramus of the mandible. An incisional biopsy was
performed. The histopathology was consistent with colorectal adenocarcinoma
metastasis. The patient was referred to a medical oncologist.
Conclusion: Differential diagnosis of mandibular lesions should be made carefully,
and
metastatic tumors should be kept in mind. In patients with history of lung
cancer, breast cancer, colorectal carcinoma or
similar tumors, oral findings such as tooth pain and tooth loss should
be taken into consideration, as these may be the signs of head and neck
metastases. Biopsy must be performed after radiological
examination.
Anahtar Kelimeler
Kaynakça
- Hirshberg A, Shnaiderman-Shapiro A, Kaplan I, Berger R. Metastatic tumours to the oral cavity—pathogenesis and analysis of 673 cases. Oral Oncol 2008;44:743–52.
- Soares AB, Thomaz LA, Duarte MT, de Camargo de Moraes P, de Araujo VC. Metastatic adenocarcinoma of the colon: early manifestation in gingival tissue. Head Neck Pathol 2011;5:140–3.
- D'Silva NJ, Summerlin DJ, Cordell KG, Abdelsayed RA, Tomich CE, Hanks CT, et al. Metastatic tumors in the jaws: A retrospective study of 114 cases. J Am Dent Assoc 2006;137:1667–72.
- Irani S. Metastasis to the Jawbones: A review of 453 cases. J Int Soc Prev Community Dent 2017;7:71-81.
- Katoh M, Unakami M, Hara M, Fukuchi S. Bone metastasis from colorectal cancer in autopsycases. J Gastroenterol 1995; 30:615-8.
- Connelly TM, Piggott RP, Waldron RM, O'Grady P. Unusual osseous metastasesfrom rectal adenocarcinoma: a case report and review of the literature. J Gastrointest Surg 2015;19:1177-86.
- Bigelow NH, Walsh TS. Metastatic carcinoma of the mandible. Ann Surg 1953;137:138–40.
- Schwartz ML, Baredes S, Mignova FV. Metastatic disease of mandible. Laryngoscope 1988;98:270-3.
- Cai Z, Zhu C, Wang L, Zhu L, Zhang Z, Zhu H, et al. A retrospective study of six patients with mandibular metastatic carcinoma. Oncol Lett 2016;11:3650–4.
- Clausen F, Poulsen H. Metastatic carcinoma to the Jaws. Acta Pathol Microbiol Scand 1963;57:361–74.
- Kesting MR, Loeffelbein DJ, Hölzle F, Wolff KD, Ebsen M. Male breast cancer metastasis presenting as submandibular swelling. Auris Nasus Larynx 2006;33:483–5.
Öz
Tanıtım:
Mandibula metastazları oldukça nadir görülür ve mandibula malignitelerinin
yaklaşık %1’inden daha azını teşkil eder. Mandibulaya metastaz olan olgularda
hastalar genellikle çenede şişlik, çene kemiği ile dişlerde ağrı, ve diş kaybı
gibi şikayetlerle başvururlar. Metastatik lezyonların belirtilerinin
periodontal hastalıklarla karışma olasılığı nedeniyle dikkatli olmak gerekir ve
ayırıcı tanıda primer kemik tümörü olan osteosarkom, primer intraosseöz skuamöz
karsinom, ameloblastoma, temporomandibuler eklem hastalıkları akılda
tutulmalıdır. Tedavi seçenekleri cerrahi ve ilave kemoradyoterapi olmakla
birlikte, prognoz kötüdür ve genellikle tedavi palyatif amaçlı yapılmaktadır.
Olgu Bildirimi:
Rektum adenokarsinomu nedeni ile 3 yıl önce opere olan 51 yaşında kadın hasta
kliniğimize çenede şişlik şikayeti ile başvurdu. Hastanın kraniyal manyetik
rezonans ve maksillofasiyal bilgisayarlı tomografi görüntüleri incelendiğinde
sağ mandibula ramusunda, kondili de tutan kemikte yıkıma yol açan lezyon
tanımlandı. Hastaya yapılan insizyonel biyopsi sonrasında histopatolojik tanı
kolorektal adenokarsinom ile uyumlu olarak raporlandı. Hasta medikal onkoloji
bölümüne yönlendirildi.
Sonuç: Mandibula lezyonlarının ayırıcı tanısı çok dikkatli
bir şekilde yapılmalı ve metastatik tümörlerin akılda tutulması gerekmektedir.
Öyküsünde akciğer, meme, kolorektal kanser ve benzeri tümörü olan hastalarda
baş boyun bölgesinde metastatik tümörlerin oluşabileceği düşünülmeli ve
dişlerde ağrı, diş kaybı dikkate alınmalı, gerekli radyolojik incelemeler
sonrası mutlaka biyopsi yapılmalıdır.
Anahtar Kelimeler
Kaynakça
- Hirshberg A, Shnaiderman-Shapiro A, Kaplan I, Berger R. Metastatic tumours to the oral cavity—pathogenesis and analysis of 673 cases. Oral Oncol 2008;44:743–52.
- Soares AB, Thomaz LA, Duarte MT, de Camargo de Moraes P, de Araujo VC. Metastatic adenocarcinoma of the colon: early manifestation in gingival tissue. Head Neck Pathol 2011;5:140–3.
- D'Silva NJ, Summerlin DJ, Cordell KG, Abdelsayed RA, Tomich CE, Hanks CT, et al. Metastatic tumors in the jaws: A retrospective study of 114 cases. J Am Dent Assoc 2006;137:1667–72.
- Irani S. Metastasis to the Jawbones: A review of 453 cases. J Int Soc Prev Community Dent 2017;7:71-81.
- Katoh M, Unakami M, Hara M, Fukuchi S. Bone metastasis from colorectal cancer in autopsycases. J Gastroenterol 1995; 30:615-8.
- Connelly TM, Piggott RP, Waldron RM, O'Grady P. Unusual osseous metastasesfrom rectal adenocarcinoma: a case report and review of the literature. J Gastrointest Surg 2015;19:1177-86.
- Bigelow NH, Walsh TS. Metastatic carcinoma of the mandible. Ann Surg 1953;137:138–40.
- Schwartz ML, Baredes S, Mignova FV. Metastatic disease of mandible. Laryngoscope 1988;98:270-3.
- Cai Z, Zhu C, Wang L, Zhu L, Zhang Z, Zhu H, et al. A retrospective study of six patients with mandibular metastatic carcinoma. Oncol Lett 2016;11:3650–4.
- Clausen F, Poulsen H. Metastatic carcinoma to the Jaws. Acta Pathol Microbiol Scand 1963;57:361–74.
- Kesting MR, Loeffelbein DJ, Hölzle F, Wolff KD, Ebsen M. Male breast cancer metastasis presenting as submandibular swelling. Auris Nasus Larynx 2006;33:483–5.
Ayrıntılar
| Konular | Sağlık Kurumları Yönetimi |
|---|---|
| Bölüm | Olgu Bildirimi |
| Yazarlar | |
| Yayımlanma Tarihi | 22 Ağustos 2017 |
| Yayımlandığı Sayı | Yıl 2018 Cilt: 35 Sayı: 1 |