Top

Oral and Maxillofacial Surgery

Published in:

01-06-2018 | Original Article

Metastases from distant primary tumours on the head and neck: clinical manifestation and diagnostics of 91 cases

Authors: Sven Holger Baum, Christopher Mohr

Published in: Oral and Maxillofacial Surgery | Issue 2/2018

Abstract

Purpose

The aim of this study was to evaluate which primary tumours metastasize on the head and neck region, identify the kind of clinical manifestation, the types of diagnostics that should be performed, and prove that the therapy appears possible and useful.

Patients

As many as 91 patients with a distant metastasis on the head and neck were enrolled in this retrospective clinical study from January 2004 to September 2016. All the patients were evaluated for clinical symptoms, primary tumour, localization, diagnostics, and surgical procedure.

Results

A total of 31 patients had asymptomatic swelling, 27 patients had symptomatic swelling, and nine experienced isolated pain without swelling. Most other symptoms were organ-specific. The most frequent localizations were the orbit (44 metastases), mandible (19), neck region (9), and skin (7). The most common primary tumours were breast carcinoma (44), bronchial carcinoma (12), and renal carcinoma (9). A biopsy was performed on 38 patients, a partial resection was done on 28 patients, extirpation on six patients, and a radical resection on 19 patients.

Conclusion

Distant metastases on the head and neck are rare and, therefore, pose a challenge for the oncologist and other involved disciplines. Most distant metastases occur within the first five years. Late metastases, especially in breast carcinoma, are still possible after 20 years. A surgical examination should be carried out if the findings are not clear due to multiple differential diagnoses. In particular, surgical options under palliative aspects should be examined.

van der Waal RI, Buter J, van der Waal I (2003) Oral metastases: report of 24 cases. Br J Oral Maxillofac Surg 41(1):3–6. https://doi.org/10.1016/S0266-4356(02)00301-7 CrossRefPubMed

Beena V, Panda S, Heera R, Rajeev R (2011) Multiple metastatic tumors in the oral cavity. Journal of oral and maxillofacial pathology : JOMFP 15(2):214–218. https://doi.org/10.4103/0973-029x.84508 CrossRefPubMedPubMedCentral

Colombo P, Tondulli L, Masci G, Muzza A, Rimassa L, Petrella D, Santoro A (2005) Oral ulcer as an exclusive sign of gastric cancer: report of a rare case. BMC Cancer 5:117. doi:https://doi.org/10.1186/1471-2407-5-117, 1

Qiu YT, Yang C, Chen MJ, Qiu WL (2013) Metastatic spread to the mandibular condyle as initial clinical presentation: radiographic diagnosis and surgical experience. Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 71(4):809–820. https://doi.org/10.1016/j.joms.2012.07.026 CrossRef

Gratz KW, Sailer HF, Makek M (1990) Osseous metastases in upper and lower jaws. Deutsche Zeitschrift fur Mund-, Kiefer- und Gesichts-Chirurgie 14(2):122–131PubMed

Sinon SH, Rich AM, Hussaini HM, Yoon HS, Firth NA, Seymour GJ (2013) Metastases to the oral region from pleural mesothelioma: Clinicopathologic review. Head Neck 35(4):599–604. https://doi.org/10.1002/hed.21942 CrossRefPubMed

Snyder MB, Cawson RA (1975) Jaw and pulpal metastasis of an adrenal neuroblastoma. Oral surgery, oral medicine, and oral pathology 40(6):775–784. https://doi.org/10.1016/0030-4220(75)90447-8 CrossRefPubMed

Lee BY, Guerra VJ, Cagir B, Herz BL, Zamurovic D (1995) Pulmonary blastoma presenting as a solitary lip metastasis: case report and review of the literature. J Spinal Cord Med 18(3):203–207. https://doi.org/10.1080/10790268.1995.11719394 CrossRefPubMed

Brasfield RD, Das Gupta TK (1970) Liposarcoma. CA Cancer J Clin 20(1):3–8CrossRefPubMed

10.

Ellis GL, Jensen JL, Reingold IM, Barr RJ (1977) Malignant neoplasms metastatic to gingivae. Oral surgery, oral medicine, and oral pathology 44(2):238–245. https://doi.org/10.1016/0030-4220(77)90274-2 CrossRefPubMed

11.

Kristensen IB, Sunde LM, Jensen OM (1986) Chondrosarcoma. Increasing grade of malignancy in local recurrence. Acta pathologica, microbiologica, et immunologica Scandinavica Section A, Pathology 94(2):73–77PubMed

12.

Taicher S, Mazar A, Hirshberg A, Dayan D (1991) Metastatic chondrosarcoma of the gingiva mimicking a reactive exophytic lesion: a case report. J Periodontol 62(3):223–226. https://doi.org/10.1902/jop.1991.62.3.223 CrossRefPubMed

13.

Meyer I, Shklar G (1965) Malignant tumors metastatic to mouth and jaws. Oral surgery, oral medicine, and oral pathology 20(3):350–362. https://doi.org/10.1016/0030-4220(65)90167-2 CrossRefPubMed

14.

Nathu RM, Mendenhall NP, Almasri NM, Lynch JW (1999) Non-Hodgkin's lymphoma of the head and neck: a 30-year experience at the University of Florida. Head Neck 21(3):247–254. https://doi.org/10.1002/(SICI)1097-0347(199905)21:3<247::AID-HED10>3.0.CO;2-6 CrossRefPubMed

15.

Ramsay AD, Smith WJ, Earl HM, Souhami RL, Isaacson PG (1987) T-cell lymphomas in adults: a clinicopathological study of eighteen cases. J Pathol 152(2):63–76. https://doi.org/10.1002/path.1711520202 CrossRefPubMed

16.

Steg RF, Dahlin DC, Gores RJ (1959) Malignant lymphoma of the mandible and maxillary region. Oral surgery, oral medicine, and oral pathology 12(2):128–141. https://doi.org/10.1016/0030-4220(59)90135-5 CrossRefPubMed

17.

Wolvius EB, van der Valk P, van der Wal JE, van Diest PJ, Huijgens PC, van der Waal I, Snow GB (1994) Primary extranodal non-Hodgkin lymphoma of the oral cavity. An analysis of 34 cases. European journal of cancer part B, Oral oncology 30b (2):121–125

18.

Dib LL, Soares AL, Sandoval RL, Nannmark U (2007) Breast metastasis around dental implants: a case report. Clin Implant Dent Relat Res 9(2):112–115. https://doi.org/10.1111/j.1708-8208.2007.00033.x CrossRefPubMed

19.

Doyle JL, Goldman HM (1966) Primary osteogenic sarcoma and metastatic renal-cell carcinoma of the mandible. Case reports and necropsy findings. Oral surgery, oral medicine, and oral pathology 21(4):419–430. https://doi.org/10.1016/0030-4220(66)90398-7 CrossRefPubMed

20.

Hartman GL, Robertson GR, Sugg WE Jr, Hiatt WR (1973) Metastatic carcinoma of the mandibular condyle: report of case. Journal of oral surgery (American Dental Association: 1965) 31(9):716–717

21.

Hatziotis JC, Constantinidou H, Papanayotou PH (1973) Metastatic tumors of the oral soft tissues. Review of the literature and report of a case. Oral surgery, oral medicine, and oral pathology 36 (4):544–550

22.

Kwon MS, Ko SO, Cho NP, Kim OH, Shin HK, Baek JA, Leem DH (2006) Gastric signet-ring cell adenocarcinoma metastatic to the gingiva: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 102(1):62–66. https://doi.org/10.1016/j.tripleo.2005.08.029 CrossRefPubMed

23.

Lund BA, Soule EH, Moertel CG (1970) Hepatocellular carcinoma with metastasis to gingival mucosa: report of case. Journal of oral surgery (American Dental Association: 1965) 28(8):604–607

24.

Sanner JR, Ramin JE, Yang CH (1979) Carcinoma of the lung metastatic to the gingiva: review of the literature and report of case. Journal of oral surgery (American Dental Association: 1965) 37(2):103–106

25.

Hirshberg A, Shnaiderman-Shapiro A, Kaplan I, Berger R (2008) Metastatic tumours to the oral cavity - pathogenesis and analysis of 673 cases. Oral Oncol 44(8):743–752. https://doi.org/10.1016/j.oraloncology.2007.09.012 CrossRefPubMed

26.

Zachariades N (1989) Neoplasms metastatic to the mouth, jaws and surrounding tissues. J Craniomaxillofac Surg 17(6):283–290. https://doi.org/10.1016/S1010-5182(89)80098-8 CrossRefPubMed

27.

D'Silva NJ, Summerlin DJ, Cordell KG, Abdelsayed RA, Tomich CE, Hanks CT, Fear D (1939) Meyrowitz S (2006) metastatic tumors in the jaws: a retrospective study of 114 cases. J Am Dent Assoc 137(12):1667–1672CrossRef

28.

Jham BC, Salama AR, McClure SA, Ord RA (2011) Metastatic tumors to the oral cavity: a clinical study of 18 cases. Head and neck pathology 5(4):355–358. https://doi.org/10.1007/s12105-011-0286-7 CrossRefPubMedPubMedCentral

29.

Franzen A, Pfaltz M (1997) Parotid tumors of non-glandular origin: local and distant metastases in the parotid gland. Laryngo- rhino- otologie 76(12):735–739. https://doi.org/10.1055/s-2007-997516 CrossRefPubMed

30.

Pretzl C, Lubbers HT, Gratz KW, Kruse AL (2014) [Metastases in the temporomandibular joint: a review from 1954 to 2013. Rare causes for temporomandibular disorders]. Swiss Dent J 124 (10):1067–1083

31.

Rentschler RE, Thrasher TV (1982) Gingival and mandibular metastases from rectal adenocarcinoma: case report and 20 year review of the english literature. Laryngoscope 92(7 Pt 1):795–797. https://doi.org/10.1288/00005537-198207000-00015 CrossRefPubMed

32.

Sauerborn D, Vidakovic B, Baranovic M, Mahovne I, Danic P, Danic D (2011) Gastric adenocarcinoma metastases to the alveolar mucosa of the mandible: a case report and review of the literature. J Craniomaxillofac Surg 39(8):645–648. https://doi.org/10.1016/j.jcms.2010.10.020 CrossRefPubMed

33.

Katsnelson A, Tartakovsky JV, Miloro M (2010) Review of the literature for mandibular metastasis illustrated by a case of lung metastasis to the temporomandibular joint in an HIV-positive patient. Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons 68(8):1960–1964. https://doi.org/10.1016/j.joms.2009.07.075 CrossRef

34.

Batson OV (1940) The function of the vertebral veins and their role in the spread of metastases. Ann Surg 112(1):138–149. https://doi.org/10.1097/00000658-194007000-00016 CrossRefPubMedPubMedCentral

35.

de Bree R, Leemans CR, Castelijns JA, Hoekstra OS (2006) The detection rate for lung metastases or synchronous lung primary tumors in patients with newly diagnosed head and neck squamous cell carcinoma. Head Neck 28(3):280–281; author reply 281-282. https://doi.org/10.1002/hed.20394 CrossRefPubMed

36.

DeBoom GW, Jensen JL, Siegel W, Bloom C (1985) Metastatic tumors of the mandibular condyle. Review of the literature and report of a case. Oral surgery, oral medicine, and oral pathology 60(5):512–516. https://doi.org/10.1016/0030-4220(85)90240-3 CrossRefPubMed

37.

Seifert G, Hennings K, Caselitz J (1986) Metastatic tumors to the parotid and submandibular glands--analysis and differential diagnosis of 108 cases. Pathol Res Pract 181 (6):684–692. doi:https://doi.org/10.1016/s0344-0338(86)80044-9

38.

Abrams HL, Spiro R, Goldstein N (1950) Metastases in carcinoma; analysis of 1000 autopsied cases. Cancer 3 (1):74–85

39.

Nuyens M, Schupbach J, Stauffer E, Zbaren P (2006) Metastatic disease to the parotid gland. Otolaryngology--head and neck surgery: official journal of American Academy of Otolaryngology-Head and Neck Surgery 135(6):844–848. https://doi.org/10.1016/j.otohns.2006.05.010 CrossRef

40.

Franzen AM, Gunzel T, Lieder A (2016) Parotid gland metastases of distant primary tumours: a diagnostic challenge. Auris Nasus Larynx 43 (2):187–191. doi:https://doi.org/10.1016/j.anl.2015.09.010

41.

Brodsky G, Rabson AB (1984) Metastasis to the submandibular gland as the initial presentation of small cell ("oat cell") lung carcinoma. Oral surgery, oral medicine, and oral pathology 58(1):76–80. https://doi.org/10.1016/0030-4220(84)90368-2 CrossRefPubMed

42.

Feinmesser R, Libson Y, Uziely B, Gay I (1986) Metastatic carcinoma to the temporal bone. The American journal of otology 7(2):119–120PubMed

43.

Jordan J, Cieszynska J, Stalke M (2004) [Metastases from distant primary tumors to the head and neck]. Otolaryngologia polska = The Polish otolaryngology 58 (3):459–467

44.

Matsumoto Y, Yanagihara N (1982) Renal clear cell carcinoma metastatic to the nose and paranasal sinuses. Laryngoscope 92(10 Pt 1):1190–1193PubMed

45.

Saldanha CB, Bennett JD, Evans JN, Pambakian H (1989) Metastasis to the temporal bone, secondary to carcinoma of the bladder. J Laryngol Otol 103(6):599–601. https://doi.org/10.1017/S0022215100109454 CrossRefPubMed

46.

Kaufmann MG, Perren A, Gratz KW, Eyrich GK (2005) Condylar metastasis. Review of the literature and report of a case. Mund-, Kiefer- und Gesichtschirurgie: MKG 9(5):336–340. https://doi.org/10.1007/s10006-005-0623-7 CrossRefPubMed

47.

Stypulkowska J, Bartkowski S, Pana's M, Zaleska M (1979) Metastatic tumors to the jaws and oral cavity. Journal of oral surgery (American Dental Association: 1965) 37(11):805–808

Title: Metastases from distant primary tumours on the head and neck: clinical manifestation and diagnostics of 91 cases
Authors: Sven Holger Baum
Christopher Mohr
Publication date: 01-06-2018
Publisher: Springer Berlin Heidelberg
Published in: Oral and Maxillofacial Surgery / Issue 2/2018
Print ISSN: 1865-1550
Electronic ISSN: 1865-1569
DOI: https://doi.org/10.1007/s10006-018-0677-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Metastases from distant primary tumours on the head and neck: clinical manifestation and diagnostics of 91 cases

Abstract

Purpose

Patients

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Patients

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 2/2018

Comparative evaluation of soft and hard tissue changes following endosseous implant placement using flap and flapless techniques in the posterior edentulous areas of the mandible—a randomized controlled trial

Behavior of C-reactive protein in association with surgery of facial fracture and the influence of dexamethasone

Prevalence of the systemic inflammatory response syndrome in patients who underwent orthognathic surgery

Postural assessment in class III patients before and after orthognathic surgery

Tactile recovery assessment with shortened Semmes-Weinstein monofilaments in patients with buccinator myomucosal flap oral cavity reconstructions

To assess the efficacy of socket plug technique using platelet rich fibrin with or without the use of bone substitute in alveolar ridge preservation: a prospective randomised controlled study