Metastatic tumors to the jaw bones: Retrospective analysis from an Indian tertiary referral center.

Aim: Being a tertiary referral center, we encounter the highest number of oral cancer patients in India, and there is direct involvement of the jaw bone in approximately 40% of these cases. There are no large case series from the Indian subcontinent on metastatic tumors to the jaw bones. With this retrospective analysis, we intend to estimate the incidence of this rare manifestation in the jaw bones in our patients and compare it with the available literature. Materials and Methods: All patients with biopsy proven metastatic disease involving jaw bones having complete clinical data were included. Results: Nineteen out of 10,411 oral cancer patients who reported between the years 2000 and 2005 were included. Breast and thyroid malignancies (5/19 each) were commonest in the females to metastasize to the mandible, whereas in the males, there was no predominant site that resulted in jaw bone metastasis, although mandible was commonly affected. Neuroblastoma of adrenal gland metastasized to maxilla in the age group ranging from 4 months to 16 years. Maxilla was the commonest jaw bone affected in this age group. In five cases, jaw bone was found to be the first site of metastasis. Conclusions: There is variation in the primary site that causes metastasis to the jaw bones depending on age, sex and geographic distribution. Jaw bone metastases are rare and can be the first site of metastasis. We get approximately four cases in a year with metastatic disease manifesting in the jaw bones. Metastasis to jaw bone is associated with poor prognosis.

[Metastasis of clear cell renal carcinoma to the maxillary gingiva in a 75-year old man: a case report]

About 1% of all oral cancers are metastases of primary tumors elsewhere in the body and could be located in the soft tissue as well as in the jaw bones. Among all the primary tumors that arise below the level of the clavicle, renal cell carcinoma [RCC] is the third most common neoplasm according to metastasis in the head and neck region. Majority of the reported cases involve the jaw bones rather than the soft tissues. Here one case of metastatic RCC to the maxillary gingival is reported. The Patient was a 75 year-old man who chiefly complained about swelling in his anterior region of the maxillary gingival. Excisional Biopsy was performed. Metastatic clear cell Renal cell carcinoma [CCRCC] was diagnosed by microscopic examination by demonstrating islands of cells separated from each other by thin fibrovascular septa, with stroma containing numerous sinusoid like vessels and immunohistochemistry [IHC] Staining [S-100, vimentin, EMA,CEA, CD 10, CK7, TTF-1 and PSA]. CT scan confirmed tumor in the right kidney. Nephrectomy and chemotherapy were performed but patient died 9 months after treatment as a result of metastases to brain and lung. CCRCC arise from renal tubular epithelium. Microscopically differential diagnosis for jaw tumors with clear cells includes a broad spectrum of tumors such as odontogenic tumors, salivary gland tumors and metastatic tumors. Generally, an immunohistochemistry panel consisting of S-100, vimentin, EMA. CEA, CD10.CK7, TTF-1 and PSA is useful to diagnose CCRCC from other clear cell tumors. Although IHC aids us in diagnosis, other paraclinical procedures like imaging should be done, to confirm the diagnosis

Metástases dos ossos gnáticos: estudo retrospectivo de 10 casos / Gnathic bone metastasis: a retrospective study of 10 cases

Metástases em cavidade oral são extremamente raras, representando 1 por cento de todas as neoplasias malignas orais. OBJETIVO: Analisar retrospectivamente a incidência de metástase nos maxilares, traçando seu perfil de comportamento epidemiológico. MATERIAL E MÉTODOS: Através de estudo retrospectivo, foram analisados o sexo, idade, localização topográfica da metástase, sítio do tumor primário e tipo histológico, no período de janeiro de 1980 a janeiro de 2000, de um total de 10 pacientes. RESULTADOS: Observou-se que 5 pacientes eram do sexo masculino (50 por cento), 3 casos ocorreram nas 2ª e 4ª décadas de vida (30 e 30 por cento). Concernente à localização topográfica da metástase, metade dos casos ocorreu na maxila e metade na mandíbula. A tireóide e próstata foram os sítios de tumor primário que mais metastizaram para os ossos gnáticos (3 casos cada) e o adenocarcinoma foi o tipo histológico de maior ocorrência de metástase (50 por cento). Conclusões: As metástases nos maxilares acometem igualmente faixa etária, sexo e localização topográfica. A tireóide e próstata parecem ser os sítios mais freqüentes de metástase à distância, e o adenocarcinoma o tipo histológico de maior incidência de metástase.

Oral cavity metastases are extremely rare, and comprise 1 percent of all mouth malignant neoplasms. AIM: to retrospectively analyze the incidence of maxillary metastases, and to trace its epidemiological behavior. MATERIAL AND METHODS: A retrospective study was done of the period between January 1980 and January 2000;the following indicators were reviewed: sex, age, site of the metastasis, site of the primary tumor, and the histological type of tumors in 10 patients. RESULTS: The prevalence was similar in males and females (05 cases - 50 percent); three cases presented in the 2nd and 4th decades of life (30 - 30 percent). About half of the cases of metastases occurred in the maxilla and half in the mandible. The thyroid and prostate glands were the most prevalent primary tumor sites for metastases (03 cases each); the adenocarcinoma histological type had the highest metastatic rate (50 percent). Conclusions: Metastasis of the jaws is very rare and may occur at any age in both the genders, where the prevalence is equal for each sex. The thyroid and prostate seem to be the most frequent sites of distance metastasis of the jaws; the adenocarcinoma is the most frequent histological type causing such metastases.

rare case of malignant ameloblastoma with Multicentric presentation

Malignant ameloblastoma accounts for less than 1% tumour of the faciomaxillary region, arising from epithelial odontogenic cells or dental lamina. The commonest site is the ascending ramus of mandible and maxilla. A rare case of malignant ameloblastoma at unusual sites is reported. It is important to identify this condition to offer adequate excision and prevent recurrence. This is a case of 9 years old male child, who presented a mass in left cheek and inguinal mass with amputated right leg. Complete excision of the maxilla and inguinal mass was carried out and confirmed as a metastatic malignant ameloblastoma both in maxilla and inguinal region. There was recurrence of the same growth in the right maxilla and skull bones after one year. This is a unique presentation of ameloblastoma spreading to remote areas in the body that has not been reported in the literature. A 9 years old male child was admitted in our ENT Department at Lady Reading Hospital, Peshawar on May-June 1998 with history of swelling left cheek and right inguinal mass. The cheek swelling appeared 10 months back and rapidly increased in size in the last 3 months. It was progressively pushing the left eye ball upward and medially with a proptosis and intact vision. There was history of nasal obstruction with blood stained nasal discharge. He had epiphora as well. On physical examination patient revealed 8x9 cm irregular solid mass of the left cheek which totally occupied the left nasal cavity with protrusion of the lateral wall, left palate and alveolus resulting in loosening of teeth. The mass was smooth and non-tender. The local temperature over the mass was normal, the overlying skin was intact and freely mobile over the mass. On systemic examination there was a mass 8x9 cm in the right inguinal region. The overlying tissue was normal, in the past patient suffered from the same lesion of the right lower limb which was amputated on October 10,1992. Mass from the right axilia was excised by the general surgeon and reported as adamantinoma on histopathology in November 13, 1996. The lesion of the left maxilla and right groin appeared during the last ten months

Metastasis of osteosarcoma to the maxilla--a case report.

Secondary osteosarcomas of the maxilla/premaxilla are extremely rare. We describe a case of a 24-year-old man with a metastasis of osteosarcoma to the premaxilla. The patient had undergone hip disarticulation followed by adria based chemotherapy for chondroblastic osteosarcoma of the proximal right femur ten years ago. The metastatic work up did not show liver or lung metastasis. The patient underwent premaxillectomy in February 1999. The histopathology revealed a chondroblatic osteosarcoma consistent with metastasis in the clinical setting. The patient was disease free at the end of five months.

Metastatic choriocarcinoma minicking as primary growth of the maxilla

The aim of this paper is to document a rare case of choriocarcinoma metastasizing to the left maxillary sinus and simulating as a primary growth of the antrum. To the best of our knowledge we have not come across any such case report in the literature. This has prompted us to present this case

Retinoblastoma familiar predispondo ao surgimento de um segundo tumor primário näo ocular / Hereditary retinoblastoma associated with a second non-ocular primary tumor

Os autores relatam um caso de retinoblastoma familiar associado ao aparecimento de um segundo tumor primário näo ocular e discutem possíveis teorias genéticas que predisporiam a estas duas neoplasias