Metastasis to the jaws as a first manifestation of hepatocellular carcinoma: Report of a case and analysis of 41 cases

Pesis, M.; Taicher, Shlomo; Greenberg, Gahl; Hirshberg, Avraham

doi:10.1016/j.jcms.2014.09.005

Cited by 16 publications

(13 citation statements)

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“…Although most oral cavity metastases are found in the presence of a widespread disease process, oral cavity metastasis might be the first manifestation of the disease in 22% to 25% of patients (Hirshberg et al, 2008; Pesis et al, 2014; Zachariades, 1989). In our study, 8 (18.2%) patients first presented with metastatic oral symptoms.…”

Section: Discussionmentioning

confidence: 99%

Metastatic solid tumors to the jaw and oral soft tissue: A retrospective clinical analysis of 44 patients from a single institution

Owosho

Kadempour

et al. 2016

Journal of Cranio-Maxillofacial Surgery

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Summary Purpose Metastatic solid tumors to the oral cavity are rare, frequently indicative of an end-stage disease process, and associated with poor survival rates. We performed a 20-year retrospective clinical analysis of our institution’s cases of solid metastases to the oral cavity, and investigated these patients’ clinical outcomes. Material and Methods A retrospective study of patients with metastatic solid tumors to the oral cavity over a 20-year period (October 1996 to September 2015) was conducted at Memorial Sloan Kettering Cancer Center. Patients were selected if they had a histopathologically confirmed diagnosis. Demographic, pathologic, and clinical information were reviewed to identify patient outcomes. Results A total of 44 patients with metastatic non-melanocytic non-hematopoietic tumor to the oral cavity were identified: 24 males and 20 females (39 adults and 5 children) with a mean age of 54.3 years. In all, 24 cases involved the jaw and 20 cases involved the oral soft tissue. Eight patients (18.2%) had oral cavity metastases as the first indication of an occult malignancy. In adult patients, the common primary sites were the lungs (n = 9, 20%), kidney (n = 7, 16%), breast (n = 5, 11%), and colon (n = 4, 9%); and in pediatric patients the adrenal gland (3/5) was the most common site. Of the adult patients, 33 (84.6%) died of disease. From the time of metastasis diagnosis, patients with jaw metastases had a median and mean survival of 12 months and 27.7 months, respectively. In comparison, patients with oral soft tissue metastases had a median survival time of 5 months, and mean of 8 months. One pediatric patient (20%) died of disease 8 months after metastasis diagnosis. Conclusion Metastatic solid tumors to the oral cavity can be the first sign of a malignancy. Pediatric patients with oral cavity metastases have a better prognosis compared to adult patients. In this series, adults with oral soft tissue involvement had shorter survival times compared to patients with jaw involvement.

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Section: Discussionmentioning

confidence: 99%

Metastatic solid tumors to the jaw and oral soft tissue: A retrospective clinical analysis of 44 patients from a single institution

Owosho

Kadempour

et al. 2016

Journal of Cranio-Maxillofacial Surgery

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“…Biopsies were used to confirm the diagnosis of a bone metastasis from HCC, particularly in cases with no history of malignancy. However, a severe hemorrhage after incisional or excisional biopsy has been reported to be relatively common in previous case reports [7,8,10,13]. Bone metastases from HCC commonly have an expansile mass that causes destruction of the involved bone, which is characterized by a similar hypervascularization to that of the primary HCC [4].…”

Section: Discussionmentioning

confidence: 97%

“…Radiotherapy was the most commonly used local treatment modality, including radiotherapy after surgery. Notably, the prescribed radiation dose and treatment response have been specified in only 6 cases [7,[10][11][12][13]23]. Table 3 summarizes the radiotherapy results in these 6 reported cases and in the 7 patients in our current series.…”

Section: Discussionmentioning

confidence: 99%

“…The most common sites of a bone https://doi.org/10.3857/roj.2019.00479 metastasis from HCC are the spine, pelvis, rib, and long bone. There are also some other less common metastatic sites such as the mandible, which was first reported by Dick et al [6] in 1957 and has since been described in several case reports and small case series [7][8][9][10][11][12][13]. Due to its rarity however, its clinical features and prognosis are not well established.…”

Section: Introductionmentioning

confidence: 99%

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Radiotherapy for mandibular metastases from hepatocellular carcinoma: a single institutional experience

Park

Yoon

2019

Radiat Oncol J

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Purpose: A mandibular metastasis is uncommon in patients with hepatocellular carcinoma (HCC). We report the clinical features of this rare lesion and evaluate the effectiveness of radiotherapy in affected patients. Materials and Methods: We retrospectively reviewed our institutional medical records for HCC patients who received radiotherapy for bone metastasis, and included cases of mandible metastasis. The clinical features of these cases, and the characteristics and outcomes of the treatments were assessed. Results: A total of 1,498 patients with a bone metastasis from HCC were treated with radiotherapy between July 1998 and April 2012 at our institution. We identified 9 patients (0.6%) in this cohort that received radiotherapy for a mandibular metastasis. The condyle was the most common location of mandibular metastasis. The median radiation dose was 40 Gy (range, 27.5 to 60 Gy), with a daily dose of 2-3 Gy. All of these 9 patients died during a median follow-up of 9 months (range, 1 to 19 months). Symptom relief was achieved in 7 of 8 patients who completed radiotherapy. Tumor size reduction was observed in 2 of 4 patients who underwent radiologic evaluation after radiotherapy. Conclusions: Metastasis to the mandible from HCC has a poor prognosis. Radiotherapy can be an effective local treatment option for symptomatic relief in these cases.

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“…The clinical presentations of HCC are highly variable. One case describes a patient presenting with oral pain and who was found to have HCC metastasized to the jaw [ 2 ]. However, even in unusual cases of HCC, it is exceedingly rare for this malignancy to present in the absence of a primary liver lesion [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Lone Hepatocellular Carcinoma: An Isolated Chest Wall Malignancy

Allencherril

Bruera

Allencherril

et al. 2017

Case Reports in Medicine

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Herein we describe the case of an elderly diabetic gentleman presenting with a two-week history of dyspnea and nonproductive cough, found to have a large left anterolateral chest wall mass. Further characterization through computed tomography (CT) of the chest revealed a soft tissue mass in the left anterior lower hemithorax found to be hepatocellular carcinoma (HCC). The liver, spleen, and pancreas were unremarkable. Diagnostic labs were unremarkable. The patient had no history of hepatitis, alcohol abuse, or illicit substance use. Pathological examination and immunohistochemical staining of the chest mass biopsy were consistent with metastatic hepatocellular carcinoma (HCC). The patient opted to pursue no further medical intervention and expired two weeks later. To the authors' knowledge, this is one of very few descriptions of isolated hepatocellular carcinoma found in the absence of a primary liver lesion and classical risk factors for hepatocarcinogenesis. This case highlights that HCC may present independently of liver lesions seen on imaging in a patient without clear signs or symptoms of liver. HCC should be considered in cases of isolated tumors with unclear primaries as ectopic carcinogenesis and occult primary malignancy are possibilities.

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Metastasis to the jaws as a first manifestation of hepatocellular carcinoma: Report of a case and analysis of 41 cases

Cited by 16 publications

References 40 publications

Metastatic solid tumors to the jaw and oral soft tissue: A retrospective clinical analysis of 44 patients from a single institution

Metastatic solid tumors to the jaw and oral soft tissue: A retrospective clinical analysis of 44 patients from a single institution

Radiotherapy for mandibular metastases from hepatocellular carcinoma: a single institutional experience

Lone Hepatocellular Carcinoma: An Isolated Chest Wall Malignancy

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