Metastasis to the oral cavity: a systematic review
DOI:
https://doi.org/10.33448/rsd-v12i2.37418Keywords:
Neoplasm metastasis; Mouth neoplasms; Systematic review.Abstract
The present study proposed to systematically review case reports of metastasis to the oral cavity and compile epidemiological, clinical, radiological, and histopathological features, intending to identify common aspects that may favor early diagnosis of such condition. Articles were found by searching the following databases: PubMed; EMBASE; LIVIVO; Web of Science; LILACS; Scopus and SciELO. The search was carried out in March 2021 by two independent researchers, with no restrictions of publication date or language. A total of 2379 studies were retrieved and 60 articles completely matched inclusion criteria, totalizing 65 cases from 19 countries. Metastasis to oral cavity cases were slightly frequent in males (1.7:1) in the sixth decade of life, manifesting in oral soft tissues (58%, 37/65), mostly originated from the lungs (20%, 13/65) as primary site. Adenocarcinoma was the most reported type of malignacy. In 51% of cases the oral metastatic lesion was the first sign of cancer and 60% of the patients already presented metastasis to other locations. In 23% of the reports, only benign lesions were considered as diagnostic hypothesis, due to a remarkable clinical resemblance to hyperplastic, reactive lesions and odontogenic infections. The survival probability at 6 months after oral metastasis diagnosis was 49%. Metastatic lesions to the oral cavity are often misdiagnosed as benign lesions; due to its severity and quick progression, they must be considered in the differential diagnosis process, conducted by a multidisplinary healthcare team comprising an oral surgeon, especially for patients with history of cancer.
References
Abe, M., Watanabe, K., Shinozaki-Ushiku, A., Ushiku, T., Abe, T., Fujihara, Y., Amano, Y., Zong, L., Wang, C. P., Kubo, E., Inaki, R., Kinoshita, N., Yamashita, S., Takai, D., Ushijima, T., Nagase, T., & Hoshi, K. (2019). Identification of a metastatic lung adenocarcinoma of the palate mucosa through genetic and histopathological analysis: A rare case report and literature review. BMC Cancer, 19(1), 1–7. https://doi.org/10.1186/s12885-019-5277-1
Aiyer, H. M., Deb, S., & Rawat, G. (2019). Metastatic hepatocellular carcinoma to the parotid gland: A diagnostic dilemma with review of the literature. Indian Journal of Pathology and Microbiology, 62(4), 682–685. https://doi.org/10.4103/IJPM.IJPM_272_19
Álvarez, C. Á., Rodríguez, B. I., Irazu, S. P., Sánchez-gracián, C. D., Vigo, C. S., & España, P. (2006). Metástasis gingival de adenocarcinoma de colon. Med Oral Patol Oral Cir Bucal, 3(1), 85–87.
Ambelil, M., Sultana, S., Roy, S., & Gonzalez, M. M. (2016). Anaplastic transformation in mandibular metastases of follicular variant of papillary thyroid carcinoma: A case report and review of the literature. Annals of Clinical and Laboratory Science, 46(5), 552–556.
Angiero, F., Moltrasio, F., Cattoretti, G., & Valente, M. G. (2011). Clinical and histopathological profile of primary or secondary osteosarcoma of the jaws. Anticancer Research, 31(12), 4485–4489.
Arslan, A., Ozcakir-Tomruk, C., Deniz, E., & Akin, O. (2016). A case report of metastasis of malignant mesothelioma to the retromolar trigone. World Journal of Surgical Oncology, 14(1), 1–7. https://doi.org/10.1186/s12957-016-0942-1
Bacac, M., & Stamenkovic, I. (2008). Metastatic cancer cell. Annual Review of Pathology: Mechanisms of Disease, 3, 221–247. https://doi.org/10.1146/annurev.pathmechdis.3.121806.151523
Cassoni, A., Terenzi, V., Bartoli, D., Zadeh, O. R., Battisti, A., Pagnoni, M., Conte, D., Lembo, A., Bosco, S., Alesini, F., & Valentini, V. (2014). Metastatic Uterine Leiomyosarcoma in the Upper Buccal Gingiva Misdiagnosed as an Epulis. Case Reports in Oncological Medicine, 2014(18), 1–4. https://doi.org/10.1155/2014/402342
Cui, Y., Cui, X. Y., Wu, Y., Yin, W. Z., & Zhu, Z. P. (2019). A case of metastasis of small cell lung cancer to the parotid gland: a case report and literature review. Journal of International Medical Research, 47(11), 5824–5830. https://doi.org/10.1177/0300060519865645
da Silva, M. C., Iwaki, L. C. V., Takeshita, W. M., Bragatto, F. P., Preis, L. de A. M., & Sigua, E. A. (2012). Carcinoma metastásico de células hepaticas en la mandíbula. Revista Cubana de Estomatologia, 49(1), 71–78.
DeBoom, G. W., Jensen, J. L., Siegel, W., & Bloom, C. (1985). Metastatic tumors of the mandibular condyle. Review of the literature and report of a case. Oral Surgery, Oral Medicine, Oral Pathology, 60(5), 512–516. https://doi.org/10.1016/0030-4220(85)90240-3
Dominici, A., Rizzo, M., Travaglini, F., Nesi, G., & Franchi, A. (2003). Non-functioning adrenal cortical carcinoma presenting with metastasis to the tongue. Journal of Oral Pathology and Medicine, 32(3), 185–187. https://doi.org/10.1034/j.1600-0714.2003.00098.x
Dong, X. R., Zhang, T., Fan, L., Zhang, S., & Wu, G. (2009). Parotid gland metastasis of nasopharyngeal carcinoma: Case report and review of the literature. Journal of International Medical Research, 37(6), 1994–1999. https://doi.org/10.1177/147323000903700638
Eisenberg, E., Natarajan, E., Yamase, H., & Hatzigiannis, G. (2007). Undifferentiated Cardiac Sarcoma Metastatic to the Maxilla: Report of a Case. Journal of Oral and Maxillofacial Surgery, 65(1), 148–151. https://doi.org/10.1016/j.joms.2006.08.008
Ferreira, M., & Malpica, A. (2009). Metastatic uterine leiomyosarcoma to the submandibular gland. Annals of Diagnostic Pathology, 13(3), 208–211. https://doi.org/10.1016/j.anndiagpath.2008.03.001
Gatti, A. P., Leal Oliva, R. N., Nardi, C. N., Yoshino Bonifaci, A. M., Tangoda, L. K., & Ramos Takahashi, L. A. (2020). Labial metastasis of renal neoplasia - A diagnostic challenge. International Journal of Surgery Case Reports, 77, 104–106. https://doi.org/10.1016/j.ijscr.2020.10.051
Hou, Y., Deng, W., Deng, G., Hu, L., Liu, C., & Xu, L. (2019). Gingival metastasis from primary hepatocellular carcinoma: A case report and literature review of 30 cases. BMC Cancer, 19(1), 1–10. https://doi.org/10.1186/s12885-019-6020-7
Hu, H., Wang, J., Zhou, X.-Y., Tong, M.-T., Zhai, C.-Y., Sui, X.-B., Zhang, Y.-H., Xie, X.-X., Liu, H., Xie, J.-S., Pan, H.-M., & Li, D. (2019). Maxillary Metastasis of Esophageal Cancer: Report of the First Case and Literature Review. Combinatorial Chemistry & High Throughput Screening, 21(10), 801–805. https://doi.org/10.2174/1386207322666190103105938
Huang, Y. C., Tung, C. L., & Lin, H. C. (2009). Gingival tumor as the first sign of advanced hepatocellular carcinoma on FDG PET/CT. Clinical Nuclear Medicine, 34(2), 72–73. https://doi.org/10.1097/RLU.0b013e318192c4e6
Ielo, N., Biancardi, M., Trevisan, F., Coimbra, C., Zelandi-Filho, C., & da Silva Santos, P. S. (2021). Jaw Metastasis from a Prostate Adenocarcinoma Associated with Numb Chin Syndrome: Case Report. SN Comprehensive Clinical Medicine, 1042–1046. https://doi.org/10.1007/s42399-020-00720-3
Jin, X., Demere, Z., Nair, K., Ali, A., Ferraro, G. B., Natoli, T., Deik, A., Petronio, L., Tang, A. A., Zhu, C., Wang, L., Rosenberg, D., Mangena, V., Roth, J., Chung, K., Jain, R. K., Clish, C. B., Vander Heiden, M. G., & Golub, T. R. (2020). A metastasis map of human cancer cell lines. Nature, 588(7837), 331–336. https://doi.org/10.1038/s41586-020-2969-2
Kanth, M. R., Prakash, A. R., Reddy, Y. R., Bai, J. K. S., & Babu, M. R. (2015). Metastasis of lung adenocarcinoma to the gingiva: A rare case report. Iranian Journal of Medical Sciences, 40(3), 287–291.
Khurram, S. A., Farthing, P. M., Whitworth, A., McKechnie, A. J., & Fernando, M. (2016). High-grade urothelial carcinoma with squamous differentiation metastasizing to the tongue. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 121(5), e111–e115. https://doi.org/10.1016/j.oooo.2015.08.017
Kilic, K., Sakat, M. S., Gozeler, M. S., & Demirci, E. (2017). Parotid gland involvement as an initial presentation of papillary thyroid carcinoma. International Journal of Oral and Maxillofacial Surgery, 46(8), 965–967. https://doi.org/10.1016/j.ijom.2017.04.002
Kirschnick, L. B., Schuch, L. F., Cademartori, M. G., & Vasconcelos, A. C. U. (2022). Metastasis to the oral and maxillofacial region: A systematic review. Oral Diseases, 28(1), 23–32. https://doi.org/10.1111/odi.13611
Kolarević, D., Tomašević, Z., Boričić, I., Rašić, D. M., Dekić, N. A., Milovanović, Z., & Jelić, S. (2011). Metastaza hepatocelularnog karcinoma kao tumor u maksilarnom sinusu i retrobulbarnom prostoru. Vojnosanitetski Pregled, 68(4), 359–362. https://doi.org/10.2298/VSP1104359K
Kolokythas, A., Miloro, M. B., Olsson, A. B., & Miloro, M. (2014). Metastatic pancreatic adenocarcinoma to the mandibular condyle: A rare clinical presentation. Journal of Oral and Maxillofacial Surgery, 72(1), 83–88. https://doi.org/10.1016/j.joms.2013.06.207
Krishnamurthy, A. (2020). Mandibular metastasis as a presenting feature of a clival chordoma. Journal of Cancer Research and Therapeutics, 16(1), 668–671.
Künzel, J., Agaimy, A., Krause, S. W., Vieth, M., & Alexiou, C. (2013). Isolated late metastasis from testicular seminoma presenting as a parotid gland mass: Case report and review of the literature. Current Oncology, 20(4), 354–358. https://doi.org/10.3747/co.20.1489
Kwon, H., Kim, N. H., Cha, Y., Kim, H. J., Jung, H. G., Koo, J. S., Yook, J. I., & Kim, H. S. (2013). A rapidly growing gingival mass. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 115(1), 2–8. https://doi.org/10.1016/j.oooo.2011.12.006
Lambert, A. W., Pattabiraman, D. R., & Weinberg, R. A. (2017). Emerging Biological Principles of Metastasis. Cell, 168(4), 670–691. https://doi.org/10.1016/j.cell.2016.11.037
Lasiter, J. C., Liess, B. D., Zitsch, R. P., & Wieberg, J. (2011). An expansile mandibular mass as the initial manifestation of hepatocellular carcinoma. Ear, Nose and Throat Journal, 90(2), 4–6. https://doi.org/10.1177/014556131109000213
Lavanya, C., Ranganathan, K., & Veerabahu, M. (2014). Mandibular metastasis of thyroid carcinoma: A case report. Journal of Clinical and Diagnostic Research, 8(7), 15–16. https://doi.org/10.7860/JCDR/2014/9079.4588
Li, M., Saghafi, N., Freymiller, E., Basile, J. R., & Lin, Y. L. (2013). Metastatic Merkel cell carcinoma of the oral cavity in a human immunodeficiency virus-positive patient and the detection of Merkel cell polyomavirus. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 115(5), e66–e71. https://doi.org/10.1016/j.oooo.2012.09.002
Liu, H., Xu, Q., Lin, F., & Ma, J. (2019). Hepatocellular carcinoma metastasis to the mandibular ramus: a case report. International Journal of Clinical and Experimental Pathology, 12(3), 1047–1051.
Majumdar, S., Uppala, D., Boddepalli, R., & Rao, A. K. (2016). A rare case of mucous adenocarcinoma with gingival metastasis: A case report and review of literature. Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology, 28(2), 197–201. https://doi.org/10.1016/j.ajoms.2015.09.002
Mathis, S., Fromont-Hankard, G., du Boisguéheneuc, F., Godenèche, G., Mahieu, F., Balaboi, I., Nocon, C., Marsac, E., & Neau, J. P. (2010). Les métastases des muscles striés. Revue Neurologique, 166(3), 295–304. https://doi.org/10.1016/j.neurol.2009.05.020
Matsuda, S., Yoshimura, H., Yoshida, H., Umeda, Y., Imamura, Y., & Sano, K. (2018). Mandibular metastasis as the first clinical indication of occult lung adenocarcinoma with multiple metastases: A case report. Medicine (United States), 97(15), 3–6. https://doi.org/10.1097/MD.0000000000010296
McKernon, S., Triantafyllou, A., & Balmer, M. C. (2013). A possible ovarian carcinoma metastatic in the mandible: Diagnostic perspectives. Oral Surgery, 6(1), 16–21. https://doi.org/10.1111/ors.12002
MELGAÇO-COSTA, J. L. B., CARNEIRO, B. T., ANTUNES, F. L., MELO, V. V. M., CARDOSO, M. F. P., & SOUTO, G. R. (2020). Oral metastasis intraosseous mimicking periapical lesion: a case report. RGO - Revista Gaúcha de Odontologia, 68, 1–6. https://doi.org/10.1590/1981-86372020000022019-0041
Mochizuki, Y., Harada, H., Oyama, J., Sakamoto, K., Michi, Y., Kuroshima, T., & kugimoto, T. (2019). Metastatic gastric adenocarcinoma of the tongue with initial symptoms of glossodynia. Current Problems in Cancer, 43(6), 100481. https://doi.org/10.1016/j.currproblcancer.2019.05.004
Moola, S., Munn, Z., Tufanaru, C., Aromataris, E., Sears, K., Sfetcu, R., Currie, M., Qureshi, R., Mattis, P., & Lisy, K. (2017). Chapter 7: Systematic reviews of etiology and risk. Joanna Briggs Institute Reviewer’s Manual. The Joanna Briggs Institute, 5.
Moser, S., Beer, M., Damerau, G., Lübbers, H. T., Grätz, K. W., & Kruse, A. L. (2011). A case report of metastasis of malignant mesothelioma to the oral gingiva. Head and Neck Oncology, 3(1), 21. https://doi.org/10.1186/1758-3284-3-21
Nambiar K, R., Anoop, T. M., Haridas, L., & Daniel, S. (2018). Numb Chin Syndrome as the Initial Manifestation of Breast Carcinoma. Indian Journal of Surgical Oncology, 9(3), 391–393. https://doi.org/10.1007/s13193-018-0752-8
Nichetti, F., Morano, F., Fabbri, A., de Braud, F., & Di Bartolomeo, M. (2018). Bilateral parotid gland metastases from gastric signet-ring cell carcinoma. Tumori, 104(6), NP10–NP13. https://doi.org/10.5301/tj.5000690
Nisi, M., Izzetti, R., Graziani, F., & Gabriele, M. (2020). Renal Cell Carcinoma Metastases to the Oral Cavity: Report of 2 Cases and Review of Literature. Journal of Oral and Maxillofacial Surgery, 78(9), 1557–1571. https://doi.org/10.1016/j.joms.2020.04.001
Park, J.-Y., Kim, H.-S., Zo, J.-I., Lee, S., & Choi, S.-W. (2006). Initial Presentation of Lung Sarcomatoid Carcinoma as a Metastatic Lesion in the Mandibular Gingiva. Journal of Periodontology, 77(4), 734–737. https://doi.org/10.1902/jop.2006.050137
Patel, S., Barros, J., Nwizu, N. N., & Ogbureke, K. U. E. (2020). Metastatic renal cell carcinoma to the oral cavity as first sign of disease: A case report. Clinical Case Reports, 8(8), 1517–1521. https://doi.org/10.1002/ccr3.2923
Peacock, Z. S., Lam, D. K., Cox, D. P., & Schmidt, B. L. (2013). Metastatic epithelioid angiosarcoma to the mandible: Report of a case and review of the literature. International Journal of Oral and Maxillofacial Surgery, 42(6), 702–706. https://doi.org/10.1016/j.ijom.2013.02.005
Ramirez, J. R., Seoane, J., Montero, J., Esparza Gómez, G. C., & Cerero, R. (2003). Isolated gingival metastasis from hepatocellular carcinoma mimicking a pyogenic granuloma. Journal of Clinical Periodontology, 30(10), 926–929. https://doi.org/10.1034/j.1600-051X.2003.00391.x
Ravi Prakash, S., Verma, S., Gill, N., & Malik, V. (2012). Multiple gingival metastasis of adenocarcinoma of the lung. Indian Journal of Dental Research, 23(4), 558–559. https://doi.org/10.4103/0970-9290.104978
Salama, A. R., Jham, B. C., Papadimitriou, J. C., & Scheper, M. A. (2009). Metastatic neuroendocrine carcinomas to the head and neck: report of 4 cases and review of the literature. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology, 108(2), 242–247. https://doi.org/10.1016/j.tripleo.2009.03.030
Salarić, I., Miloš, M., Brajdić, D., Manojlović, S., Ostović, K. T., & Macan, D. (2016). Bronchogenic adenocarcinoma metastatic tumor mimicking a dentoalveolar abscess in the maxilla. Quintessence International, 47(9), 785–790. https://doi.org/10.3290/j.qi.a36324
Santana, L. A. da M., Felix, F. A., de Arruda, J. A. A., da Silva, L. P., Brito, É. de A. C., Takeshita, W. M., & Trento, C. L. (2020). A rare case of a metastatic giant cell–rich osteosarcoma of the mandible: Update and differential diagnostic considerations. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 00(00), 1–7. https://doi.org/10.1016/j.oooo.2020.10.009
Schmidt-Westhausen, A., Reichart, P. A., & Gross, U. M. (1996). Gingival metastasis of Merkel cell carcinoma: A case report. Journal of Oral Pathology and Medicine, 25(1), 44–47. https://doi.org/10.1111/j.1600-0714.1996.tb01222.x
Shetty, V., & Sriram S., G. (2017). Recurrent Retinoblastoma With Mandibular Metastasis: A Case Report. Journal of Oral and Maxillofacial Surgery, 75(3), 560–564. https://doi.org/10.1016/j.joms.2016.09.027
Shibue, T., & Weinberg, R. A. (2011). Metastatic colonization: Settlement, adaptation and propagation of tumor cells in a foreign tissue environment. Seminars in Cancer Biology, 21(2), 99–106. https://doi.org/10.1016/j.semcancer.2010.12.003
Stanek, J., Vahidi, S., Wilke, C. T., & Khaja, S. F. (2019). Malignant paraganglioma presenting as a mandibular metastasis. Head and Neck, 41(5), E66–E70. https://doi.org/10.1002/hed.25575
Steeg, P. S. (2016). Targeting metastasis. Nature Reviews Cancer, 16(4), 201–218. https://doi.org/10.1038/nrc.2016.25
Steffen, C., Doll, C., Thieme, N., Waluga, R., & Beck-Broichsitter, B. (2020). Presentation of cervical metastases and pathological mandibular fracture due to pulmonal adenocarcinoma: A case report. International Journal of Surgery Case Reports, 70, 53–55. https://doi.org/10.1016/j.ijscr.2020.04.044
Sugawara, C., Takahashi, A., Kawano, F., Kudoh, T., Yamada, A., Ishimaru, N., Hara, K., & Miyamoto, Y. (2015). Neuroendocrine tumor in the mandible: A case report with imaging and histopathologic findings. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 119(1), e41–e48. https://doi.org/10.1016/j.oooo.2014.09.024
Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F. (2021). Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 0(0), 1–41. https://doi.org/10.3322/caac.21660
Syrigos, K. N., Katirtzoglou, N., Ntomi, V., Pierrakou, A., Chorti, M., Stratakos, G., Dannos, I., & Saif, M. W. (2012). Pulmonary blastoma with submandibular, scrotum and adrenal metastases: Case report. Respiration, 83(1), 83–86. https://doi.org/10.1159/000324265
Tamura, T., Kodani, I., Kidani, K., Takubo, K., Oki, M., Sakai, H., Amekawa, S., Doi, R., Tanio, K., & Ryoke, K. (2008). A 6-year controlled gastric adenocarcinoma metastasized to the lung, cervical spine and mandible in a Japanese male: A patient report. Yonago Acta Medica, 51(2), 49–54.
Vassar, M., Atakpo, P., & Kash, M. J. (2016). Manual search approaches used by systematic reviewers in dermatology. Journal of the Medical Library Association, 104(4), 302–304. https://doi.org/10.3163/1536-5050.104.4.009
Wu, Z., Tang, J., Li, Y., Lu, H., Xu, J., & Lv, D. (2017). Successful management of rare gingival metastasis from gastric adenocarcinoma: A case report and literature review. World Journal of Surgical Oncology, 15(1), 1–5. https://doi.org/10.1186/s12957-017-1215-3
Yoshiba, S., Saotome, T., Mikogami, T., & Shirota, T. (2017). Metastasis of Mammary Gland Malignant Phyllodes Tumor to the Mandibular Region: A Case Report and Review of the Literature. Journal of Oral and Maxillofacial Surgery, 75(2), 440.e1-440.e9. https://doi.org/10.1016/j.joms.2016.09.024
Zandi, M., Jafari, M., Isapour, M., & Jafari, A. A. (2014). Mandibular metastasis in a patient with undiscovered synchronous thyroid and prostate cancer: A diagnostic dilemma. Journal of Oral and Maxillofacial Pathology, 18(3), 449–452. https://doi.org/10.4103/0973-029X.151347
Zhang, L., Yang, H., & Zhang, X. (2014). Metastatic renal cell carcinoma to the jaws: Report of cases. World Journal of Surgical Oncology, 12(1), 2–5. https://doi.org/10.1186/1477-7819-12-204
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Larissa Fernanda dos Santos Lima Macedo; André Pereira Falcão; Wladimir Gushiken de Campos; Celso Augusto Lemos Júnior; Lucyene Miguita; Carina Domaneschi
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.