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Metastatic disease to the mandible.
M L Schwartz1, S Baredes, F V Mignogna
1Head and Neck Surgical Associates, Englewood, NJ 07631.
The Laryngoscope
|March 1, 1988
Summary
Metastatic disease to the mandible is rare, often presenting as a mass or swelling. Early detection through imaging is crucial, as it can be the first sign of widespread cancer.
Area of Science:
- Oncology
- Oral and Maxillofacial Surgery
- Radiology
Background:
- Metastatic lesions to the mandible are uncommon, representing less than 1% of all malignancies.
- A review of 17 cases diagnosed between 1938 and 1985 provides insights into this rare condition.
Purpose of the Study:
- To analyze the clinical presentation, diagnostic challenges, and management of metastatic disease to the mandible.
- To highlight the importance of considering metastatic disease in patients with mandibular masses.
Main Methods:
- Retrospective review of 17 patient records with metastatic disease to the mandible.
- Analysis of patient demographics, primary tumor types, presenting signs, and treatment outcomes.
Main Results:
- The most common presenting sign was a mandibular or paramandibular mass or swelling.
- Breast, lung, and colon cancers were the most frequent primary tumors.
- Mandibular metastasis preceded the primary tumor diagnosis in 3 patients and was the initial sign of distant disease in 11 of 17 patients.
Conclusions:
- A high index of suspicion is essential for diagnosing mandibular metastasis, especially with an isolated mass.
- Imaging modalities like technetium or CT scans are vital for detecting osseous destruction when plain X-rays are normal.
- Treatment is typically palliative, but surgical resection may be an option for solitary metastases.