Retrospective Analysis of Maxillofacial Metastasis Case Reports in Literature

Yıl 2020, Ağız Kanserleri Özel Sayısı, 233 - 240, 28.09.2020

Özlem Görmez , Elif Çelebi , Mehmet Egemen Aydemir , Derya Yıldırım

https://doi.org/10.20515/otd.772105

Öz

Metastatic tumors are observed rarely in maxillofacial region, usually appear in late stage as an indicator of a widespread disease and have poor prognosis. The aim of this study was to evaluate the current literature about metastatic tumor cases in maxillofacial region and to report their clinical and radiological features. Pubmed database were searched for published case reports of maxillofacial metastatic tumors in last 5 years. Patients’ age, gender, histologic diagnosis of primary and metastatic tumors, location, clinical and radiological findings, treatment and prognosis were recorded. As a result of literature review, 1469 articles were found. Titles and abstracts were analyzed and 131 maxillofacial metastasis case reports were detected. The articles with insufficient information excluded and 91 patients (58 male, 33 female) in 89 case reports were evaluated. The most common primary tumor sites were kidney (27,6%) for males and breast (27,3%) for females. Mandibular bone (28,6%) and gingiva (26,4%) were most frequent sites of maxillofacial metastasis. Swelling (54,9%) and pain (31,9%) were the most common clinical signs and symptoms. In 35.2% of the cases, the tumor in the maxillofacial region was diagnosed before the primary tumor. It was observed that all clinical and radiographic information about patients were not reported in many case reports. Malignancies of different regions can cause maxillofacial metastasis. Due to the absence of pathognomonic signs and symptoms of metastatic tumors, a detailed clinical, radiological and histopathological examination is required for differential diagnosis. Clinicians should consider that a diagnosed malignancy in maxillofacial region may be metastasis and may even give signs and symptoms before the diagnosis of primary tumor.

Anahtar Kelimeler

Mouth Neoplasm, Neoplasm Metastasis, Head and Neck Neoplasms, Early Diagnosis Of Cancer

Literatürdeki Maksillofasiyal Metastaz Vakalarının Retrospektif Analizi

Öz

Metastatik tümörler maksillofasiyal bölgede nadir görülmekte, genellikle geç evrede, yaygın bir hastalığın göstergesi olarak ortaya çıkmakta ve prognozu kötü olmaktadır. Bu çalışmanın amacı maksillofasiyal bölgedeki metastatik tümör vakalarıyla ilgili güncel literatürü değerlendirerek, vakaların klinik ve radyolojik özelliklerini bildirmektir.
Gereç ve Yöntem: Pubmed veri tabanında, son 5 yıl içerisinde vaka raporu olarak yayınlanmış maksillofasiyal bölge metastatik tümörleri tarandı. Hastaların yaş ve cinsiyet bilgileri, primer ve metastatik tümörün histolojik tanısı, bulunduğu bölge, klinik ve radyolojik bulguları, tedavi ve prognozu analiz edildi.
Bulgular: Literatürün incelenmesi sonucunda, 1469 makale bulundu. Başlık ve özetleri incelendi ve maksillofasiyal bölgede metastaz bulunan 131 vaka raporu belirlendi. Yetersiz hasta ve metastaz bilgisi bulunan makaleler inceleme dışı bırakılarak, değerlendirmeye uygun olan 89 vaka raporunda 91 hastanın (58 erkek, 33 kadın) bilgileri incelendi. Primer tümör bölgeleri erkeklerde en sık böbrek (% 27,6), kadınlarda meme (% 27,3) olarak tespit edildi. Mandibular kemik (% 28,6) ve gingiva (% 26,4) maksillofasiyal metastazın en sık görüldüğü bölgelerdi. En sık gözlenen klinik bulgu ve belirti şişlik (% 54,9) ve ağrı (% 31,9) olarak belirlendi. Olguların % 35,2’sinde maksillofasiyal bölgedeki tümörün primer tümörden önce teşhis edildiği belirlendi.
Sonuç: Literatür incelemesi sonucunda, birçok vaka raporunda, hasta ve klinik bilgilerinin tümünün belirtilmediği gözlendi. Farklı bölgedeki maligniteler, maksillofasiyal metastaz yapabilir. Metastatik tümörlerde patognomonik bulgu ve belirtilerin olmaması nedeniyle ayırıcı tanıda detaylı bir klinik, radyolojik ve histopatolojik inceleme gerekmektedir. Klinisyenler, maksillofasiyal bölgede yeni teşhis edilen bir malignitenin uzak bölgelerden metastaz olabileceğini ve primer tümörden önce bulgu ve belirti verebileceğini göz önünde bulundurmalıdır.

Anahtar Kelimeler

Ağız neoplazileri, Tümör metastazı, Baş ve boyun neoplazileri, Kanserin Erken Teşhisi

Kaynakça

• McClure SA, Movahed R, Salama A et al. Maxillofacial metastases: a retrospective review of one institution's 15-year experience. J Oral Maxillofac Surg. 2013;71(1):178-88.
• Duffy MJ, McGowan PM, Gallagher WM. Cancer invasion and metastasis: changing views. J Pathol. 2008;214(3):283-93.
• Sethi N, Kang Y. Unravelling the complexity of metastasis - molecular understanding and targeted therapies. Nat Rev Cancer. 2011;11(10):735-48.
• Hirshberg A, Berger R, Allon I et al. Metastatic tumors to the jaws and mouth. Head Neck Pathol. 2014;8(4):463-74.
• Allon I, Pessing A, Kaplan I et al. Metastatic tumors to the gingiva and the presence of teeth as a contributing factor: a literature analysis. J Periodontol. 2014;85(1):132-9.
• Hirshberg A, Buchner A. Metastatic tumours to the oral region. An overview. Eur J Cancer B Oral Oncol. 1995;31B(6):355-60.
• Hirshberg A, Shnaiderman-Shapiro A, Kaplan I et al. Metastatic tumours to the oral cavity - pathogenesis and analysis of 673 cases. Oral Oncol. 2008;44(8):743-52.
• Lee YH, Lee JI. Metastatic carcinoma of the oral region: An analysis of 21 cases. Med Oral Patol Oral Cir Bucal. 2017;22(3):e359-e365.
• Nguyen DX, Bos PD, Massagué J. Metastasis: from dissemination to organ-specific colonization. Nat Rev Cancer. 2009;9(4):274-84.
• Hirshberg A, Leibovich P, Buchner A. Metastases to the oral mucosa: analysis of 157 cases. J Oral Pathol Med. 1993;22(9):385-90.
• Hirshberg A, Leibovich P, Buchner A. Metastatic tumors to the jawbones: analysis of 390 cases. J Oral Pathol Med. 1994;23(8):337-41.
• Nifosì G, Bressand H, Nifosì AF et al. Epulis-like presentation of gingival renal cancer metastasis. Case Rep Oncol. 2017;10(2):758-763.
• Miyake M, Takebayashi R, Ohbayashi Y et al. Metastasis in the gingiva from colon adenocarcinoma. J Maxillofac Oral Surg. 2015;14(Suppl 1):279-82.
• Lim SY, Kim SA, Ahn SG et al. Metastatic tumours to the jaws and oral soft tissues: a retrospective analysis of 41 Korean patients. Int J Oral Maxillofac Surg. 2006;35(5):412-5.
• Moraes RM, Alves FA, Carvalho BFDC et al. Mandible metastasis of small cell lung cancer mimicking a residual cyst. Autops Case Rep. 2017;7(1):37-41.
• Nishimura Y, Yakata H, Kawasaki T et al. Metastatic tumours of the mouth and jaws. A review of the Japanese literature. J Maxillofac Surg. 1982;10(4):253-8.
• Irani S. Metastasis to the jawbones: A review of 453 cases. J Int Soc Prev Community Dent. 2017;7(2):71-81.
• Murillo J, Bagan JV, Hens E et al. Tumors metastasizing to the oral cavity: a study of 16 cases. J Oral Maxillofac Surg. 2013;71(9):1545-51.
• Fives C, Feeley L, O'Leary G et al. Importance of lymphovascular invasion and invasive front on survival in floor of mouth cancer. Head Neck. 2016;38(Suppl 1):E1528-34.
• Pires FR, Ramos AB, Oliveira JB et al. Oral squamous cell carcinoma: clinicopathological features from 346 cases from a single oral pathology service during an 8-year period. J Appl Oral Sci. 2013;21(5):460–467.
• Van der Waal RI, Buter J, Van der Waal I. Oral metastases: report of 24 cases. Br J Oral Maxillofac Surg. 2003;41(1):3-6.