Report of six cases of metastatic jaw tumours in Nigerians

Abstract

Background: Metastatic tumours make up approximately one per cent of all oral malignancies. Such tumours may present in the jawbones and oral soft tissues. The commonest oral site is the mandible. Nigerian reports of metastatic tumours to the jaws are very rare. Method: This is a retrospective study of six cases of metastatic tumours to the jaws seen at the Maxillofacial Unit, Ahmadu Bello University Hospital, Kaduna from1979-1998,representing 1% of all histologically confirmed malignant jaw tumours in the hospital. Results: Unlike in other reports, most (three of our six cases) originated from the thyroid gland while the rest were from the breast, uterus and the nasopharynx. More of our lesions occurred in the mandible (4) than the maxilla (2) and almost all patients presented with oral complaints oblivious of the primary malignancy. These complaints resemble those from odontogenic infections and benign neoplasms. The most common histological type of metastatic tumours in this study was the adenocarcinoma (50%). Conclusion:In view of the similarity in presentation of metastatic lesions to the jaws and other odontogenic tumours and even infections, a high index of clinical suspicion is advocated to ensure early, multidisciplinary care of patients.

Lytic lesion of the mandible revealing a metastatic breast cancer

“…For this distant metastasis, between the initial diagnosis and the development of the first metastasis there is a median time of 29.0 months (3–176 months) and a post-metastasis overall survival (OS) of about 31.0 months (0–173 months) [ 35 ]. Early detection requires accurate examination, and microscopic evaluation is essential.…”

“…Resorption of teeth is rare, teeth may seem to be floating in a soft tissue mass and may be in an altered position because of loss of bony support. On occasion, extension to other structures and destruction of adjacent cortical bone occurs [ [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] ]. The tumor breaches the outer cortical plate of the jaws and extends into surrounding soft tissues, presenting as an extraoral mass as the present case [ [32] , [33] , [34] , [35] , [36] ].…”

“…Indeed, once breast cancer metastasizes to the bone, the 5 years relative survival rate falls to under 10 % [ [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] ]. This case emphasizes the importance of a complete and careful workup with particular attention to detailed medical history as well as careful clinical, radiographic, and histopathologic examination.…”

“…In healthy patient who respond properly to primary tumor therapy, therapeutic modalities of metastatic lesion to the oral cavity include predominantly radiotherapy, chemotherapy and hormonal therapy [ [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] ]. Major concern should be given for relieving pain and avoiding infections, fractures or hemorrhage [ 37 ].…”

Lytic lesion of the mandible revealing a metastatic breast cancer

“…For this distant metastasis, between the initial diagnosis and the development of the first metastasis there is a median time of 29.0 months (3–176 months) and a post-metastasis overall survival (OS) of about 31.0 months (0–173 months) [ 35 ]. Early detection requires accurate examination, and microscopic evaluation is essential.…”

“…Resorption of teeth is rare, teeth may seem to be floating in a soft tissue mass and may be in an altered position because of loss of bony support. On occasion, extension to other structures and destruction of adjacent cortical bone occurs [ [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] ]. The tumor breaches the outer cortical plate of the jaws and extends into surrounding soft tissues, presenting as an extraoral mass as the present case [ [32] , [33] , [34] , [35] , [36] ].…”

“…Indeed, once breast cancer metastasizes to the bone, the 5 years relative survival rate falls to under 10 % [ [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] ]. This case emphasizes the importance of a complete and careful workup with particular attention to detailed medical history as well as careful clinical, radiographic, and histopathologic examination.…”

“…In healthy patient who respond properly to primary tumor therapy, therapeutic modalities of metastatic lesion to the oral cavity include predominantly radiotherapy, chemotherapy and hormonal therapy [ [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] ]. Major concern should be given for relieving pain and avoiding infections, fractures or hemorrhage [ 37 ].…”

Primary Squamous Cell Carcinoma of Lung Leading to Metastatic Jaw Tumor

“…The treatment option and prognosis depends upon site of origin and degree of metastatic spread. In a study conducted by Adebayo and Ajike, 19 of 24 cases (79%) of oral metastatic tumors died within 12 months of diagnosis which attributed to the poor prognosis of oral metastasis [ 10 ]. Treatment modalities include surgical resection, radiation, chemotherapy, or a combination of these techniques.…”

Lytic lesion of the mandible revealing a metastatic breast cancer

“…For this distant metastasis, between the initial diagnosis and the development of the first metastasis there is a median time of 29.0 months (3–176 months) and a post-metastasis overall survival (OS) of about 31.0 months (0–173 months) [ 35 ]. Early detection requires accurate examination, and microscopic evaluation is essential.…”

“…Resorption of teeth is rare, teeth may seem to be floating in a soft tissue mass and may be in an altered position because of loss of bony support. On occasion, extension to other structures and destruction of adjacent cortical bone occurs [ [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] ]. The tumor breaches the outer cortical plate of the jaws and extends into surrounding soft tissues, presenting as an extraoral mass as the present case [ [32] , [33] , [34] , [35] , [36] ].…”

“…Indeed, once breast cancer metastasizes to the bone, the 5 years relative survival rate falls to under 10 % [ [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] ]. This case emphasizes the importance of a complete and careful workup with particular attention to detailed medical history as well as careful clinical, radiographic, and histopathologic examination.…”

“…In healthy patient who respond properly to primary tumor therapy, therapeutic modalities of metastatic lesion to the oral cavity include predominantly radiotherapy, chemotherapy and hormonal therapy [ [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] ]. Major concern should be given for relieving pain and avoiding infections, fractures or hemorrhage [ 37 ].…”

Primary Squamous Cell Carcinoma of Lung Leading to Metastatic Jaw Tumor

“…The treatment option and prognosis depends upon site of origin and degree of metastatic spread. In a study conducted by Adebayo and Ajike, 19 of 24 cases (79%) of oral metastatic tumors died within 12 months of diagnosis which attributed to the poor prognosis of oral metastasis [ 10 ]. Treatment modalities include surgical resection, radiation, chemotherapy, or a combination of these techniques.…”

Lytic lesion of the mandible revealing a metastatic breast cancer

“…For this distant metastasis, between the initial diagnosis and the development of the first metastasis there is a median time of 29.0 months (3–176 months) and a post-metastasis overall survival (OS) of about 31.0 months (0–173 months) [ 35 ]. Early detection requires accurate examination, and microscopic evaluation is essential.…”

“…Resorption of teeth is rare, teeth may seem to be floating in a soft tissue mass and may be in an altered position because of loss of bony support. On occasion, extension to other structures and destruction of adjacent cortical bone occurs [ [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] ]. The tumor breaches the outer cortical plate of the jaws and extends into surrounding soft tissues, presenting as an extraoral mass as the present case [ [32] , [33] , [34] , [35] , [36] ].…”

“…Indeed, once breast cancer metastasizes to the bone, the 5 years relative survival rate falls to under 10 % [ [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] ]. This case emphasizes the importance of a complete and careful workup with particular attention to detailed medical history as well as careful clinical, radiographic, and histopathologic examination.…”

“…In healthy patient who respond properly to primary tumor therapy, therapeutic modalities of metastatic lesion to the oral cavity include predominantly radiotherapy, chemotherapy and hormonal therapy [ [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] ]. Major concern should be given for relieving pain and avoiding infections, fractures or hemorrhage [ 37 ].…”

Primary Squamous Cell Carcinoma of Lung Leading to Metastatic Jaw Tumor

“…The treatment option and prognosis depends upon site of origin and degree of metastatic spread. In a study conducted by Adebayo and Ajike, 19 of 24 cases (79%) of oral metastatic tumors died within 12 months of diagnosis which attributed to the poor prognosis of oral metastasis [ 10 ]. Treatment modalities include surgical resection, radiation, chemotherapy, or a combination of these techniques.…”