Metastatic Cancers to the Oral Cavity: A 42-Year Experience

Metastatic cancers to the oral cavity are rare and often indicate a widespread metastatic disease with an unfavorable prognosis. This study aimed to determine their frequency, demographics, and clinical profiles in Thailand.

Pathology records were reviewed from 1983 to 2024 for cases diagnosed with metastatic cancers involving the oral cavity. Demographic, clinical, and radiographic data were collected and analyzed.

Of 4057 oral malignancies, 71 (1.8%) were metastatic cancers. Males accounted for 56.3%, while females accounted for 43.7%. The mean age at diagnosis was 61.1 ± 9.9 years. Nodular swelling (59.2%) was the most common clinical presentation, and 77.5% of patients reported pain. Jawbone metastases were 1.5-fold more common than oral mucosal metastases. Most lesions involved the posterior mandible (28.2%) and showed radiolucency radiographically (77.0%). Gingiva (22.5%) was the most common oral mucosal metastatic site. In 12.7% of cases, the primary lesions were not diagnosed at the time of oral presentation. The most common oral metastatic cancers in males were colorectal cancer, followed by lung cancer. In females, breast cancer was the most frequent primary site, followed by thyroid cancer.

The variable distribution of oral metastases across populations suggests geographic and sex-related disparities in the prevalence of the primary malignancies. Their clinical presentations can vary significantly, posing a diagnostic challenge. This study provides a valuable database for clinicians to consider oral metastases in the differential diagnosis of lesions with painful swelling of oral mucosal tissues or jawbones, particularly in older individuals with a history of cancer.