Pattern and Outcome of Metastatic Malignant Lesions to the Jaws: A Systematic Review of 594 Cases

The jaws are affected secondarily by metastasis from a distant site. Metastatic lesions of jaws are very rare and constitute about 1% of all the malignancies occurring in the jaw, and the pattern of metastasis differs by age and sex. The objective of this review was to analyze the pattern of metastatic jaw lesions and its outcome. This was a systematic review of cases of metastatic jaw lesions published between 1950 and 2022. An electronic search of PubMed, Scopus, Web of Science, African Journals Online, and Google Scholar was performed. Only case reports or case series with histopathological results demonstrating metastasis to the jaws were included. The main outcomes included demographics, primary site, metastatic site, clinical manifestations, and patient survival. Descriptive and multivariate analysis and a Kaplan-Meier survival curve were performed. A total of 450 articles were selected with a total of 594 cases. The mean age of the patients was 54.31 (SD = 19.49) years with a median age of 58 (IQR = 47-68) years. There were slightly more females (N = 299, 50.3%) with a male-to-female ratio of 1:1.01. The most common malignant lesion to metastasize to the jaws was adenocarcinoma (N = 230, 38.7%). In females, the frequent sites of the primary lesion were the breast (N = 99, 33.1%), thyroid (N = 52, 17.4%), and lungs (N = 27, 9.0%), whereas in males they were the lung (N = 57, 19.3%) the prostate (N = 41, 13.9%), liver (N = 36, 12.2%), and kidney (N = 28, 9.5%). The frequently reported clinical symptoms include jaw swelling (N = 460, 77.4%), pain (N = 250, 42.1%), paresthesia (N = 117, 29.8%), and trismus (N = 72, 12.1%). Regarding the outcome, 65.3% had succumbed to the disease at the time of publication of their cases. The survival of patients with metastatic jaw lesions did not depend on the demographics of the patient, the primary site, and the treatment of the primary lesion. Metastasis to the jaw bone is very rare and its prognosis is poor. Females and the elderly are more affected. The most common primary malignant lesion is adenocarcinoma. Most of the clinicians misdiagnosed the metastatic jaw lesion on initial presentation. Factors determining the survival of patients with metastatic jaw lesions could not be ascertained.

The online version contains supplementary material available at 10.1007/s12070-024-05120-w.