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

Abstract

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.

Analytic survey of 57 cases of oral metastases

“…This element is highlighted by two recent case series. While a collection of 44 cases from Memorial Sloan Kettering demonstrated a similar sex ratio of male to female patients and proclivities for lung and breast metastases, they discovered only a singular case of liver origin . Additional studies from cohorts of Korean patients did find metastases of liver origin to be among most common, which they note as discordant with the Western literature .…”

Oral and Maxillary Metastases: Retrospective Clinical Analysis of 21 Cases

“…A literature review of recent similar single/double institution case-series as ours is performed, with more than 15 cases and a 10-year period minimum (Table III) 5,[7][8][9][10][11][12][13][14][15][16][17][18][19] . Inclusion and exclusion criteria are very heterogeneous.…”

“…Mean age is between the 5 th and 7 th decades, but oral metastases could develop at any age. Some studies consider for their analysis children versus adults, because of radically different lineage, origin and better prognosis in the first ones 17 . Most common tissue lineage of solid tumours is epithelial, carcinomas or and adenocarcinomas, in all the series.…”

A challenging palliation via novel therapeutic approach for unusual presenting with gingival metastasis from renal cell carcinoma relapsed eight years after nephrectomy

“…In 15% of the cases with disseminated renal cell carcinoma (RCC), oral cavity metastases can be seen and in most of the patients' synchronous involvement of other body regions can be observed. Clinical manifestations resemble to those detected in frequently seen inflammatory reactive and non-malignant systemic diseases of the oral cavity [4]. In differential diagnosis, in addition to histopathological examination, immunohistochemical staining is a very useful guiding tool in the characterization of primary tumor.…”

“…More than 80% of metastatic tumors arise from jaw bone and especially from its premolar and molar regions. However predominantly, soft tissue of gingiva (54%) and tongue (33%) are involved [1][2][3][4]. In most of the patients, previous diagnosis of primary tumor is already known, however oral cavity metastasis can encounter us as the first sign in 22-25% of the patients [1].…”