IADR Abstract Archives
Metastatic Tumors in Oral Mucosa and Jawbones: Unusual Primary Origins and Unusual Oral Locations
Objectives: Clinico-pathological characterization of a large series of oral metastases, from 3 medical centers in Israel, in comparison to frequency of primary cancer types in the population.
Methods: Retrospective analysis of oral mucosa and jawbone metastasis from pathology archive material 1990 – 2016. Metastases to skin and major salivary glands have been excluded. Demographic data and histopathological features were analyzed.
Results: Study population included 60 patients, 35 F: 25 M, age range 17-87 years, mean 67.7. Only 3 (5%) patients were under 40 years, the remaining clustered predominantly in the 60-80 age group. There was an almost equal distribution between the oral soft tissue and the jawbones (48.3% , 51.7%, respectively). The five most common organs from which metastases were distributed to the oral cavity and jawbones combined were kidney (20%), breast (15%), cutaneous (predominately melanoma,13%), lung (11.7%) and soft tissue-sarcomas (8.3%). For comparison, in Israel National Cancer Registry 2013 the most frequent malignancies were breast (25.8%), colorectal cancer (16.3%), lung (12%) and prostate (10%). Malignant melanoma was 6th (5.4%), kidney malignancy was only 9th in frequency (4.2%). Although the gingiva and jawbones were the most frequent locations, some cases presented in unusual locations, (mandibular vestibule, lower lip, posterior dorsal tongue), without any specific clinical feature to suggest metastasis.
Conclusions: The most frequent primary origins for oral metastasis do not correspond to the relative frequency of the primary tumors in the population, indicating that metastatic spread is not a random process. Although the majority of metastasis involves the gingiva and jawbones, any other oral mucosal location might be involved. Thus, in adult/older patients, metastasis from a distant site should be included in the differential diagnosis of oral masses at any oral location, whether the existence of a primary tumor is reported or not.
Methods: Retrospective analysis of oral mucosa and jawbone metastasis from pathology archive material 1990 – 2016. Metastases to skin and major salivary glands have been excluded. Demographic data and histopathological features were analyzed.
Results: Study population included 60 patients, 35 F: 25 M, age range 17-87 years, mean 67.7. Only 3 (5%) patients were under 40 years, the remaining clustered predominantly in the 60-80 age group. There was an almost equal distribution between the oral soft tissue and the jawbones (48.3% , 51.7%, respectively). The five most common organs from which metastases were distributed to the oral cavity and jawbones combined were kidney (20%), breast (15%), cutaneous (predominately melanoma,13%), lung (11.7%) and soft tissue-sarcomas (8.3%). For comparison, in Israel National Cancer Registry 2013 the most frequent malignancies were breast (25.8%), colorectal cancer (16.3%), lung (12%) and prostate (10%). Malignant melanoma was 6th (5.4%), kidney malignancy was only 9th in frequency (4.2%). Although the gingiva and jawbones were the most frequent locations, some cases presented in unusual locations, (mandibular vestibule, lower lip, posterior dorsal tongue), without any specific clinical feature to suggest metastasis.
Conclusions: The most frequent primary origins for oral metastasis do not correspond to the relative frequency of the primary tumors in the population, indicating that metastatic spread is not a random process. Although the majority of metastasis involves the gingiva and jawbones, any other oral mucosal location might be involved. Thus, in adult/older patients, metastasis from a distant site should be included in the differential diagnosis of oral masses at any oral location, whether the existence of a primary tumor is reported or not.