Main Article Content
Metastasis to the oral cavity rarely occurs and constitutes 1% of all oral cavity malignancies and have been mostly detected in the jaw bones and especially in the mandible. Thyroid cancers have accounted for up to 6% of the oral cavity metastases, occurring more frequently in follicular variants. Because of the hypervascularity of these tumors, the diagnosis of vascular malformation must be discussed and vascular control should be assured in order to avoid any hemorrhagic incident. In the current work, we present a rare case of a hypervascular mandibular metastasis of thyroid carcinoma of a 65 year old female patient. After examination and confirmation, a decision was taken to resect the metastatic mandibular mass in the same time of a total thyroidectomy. Because of the risk of excessive bleeding of the high flow mandibular lesion, the left external carotid artery was ligated first. The histopathologic study of the surgical specimen revealed a follicular thyroid carcinoma of the thyroid gland with extracapsular extension and vascular invasion, a metastatic follicular thyroid carcinoma to the mandible. The patient received 150 milli-curies dose of radioactive Iodine-131 postoperatively. She is on regular follow up and actually disease free. In conclusion, the clinical presentation of a metastatic lesion to the jaw bone, especially to the mandible, can be challenging to a clinician and a consideration for metastatectomy should be made for a secondary tumor from a thyroid primary, given its potential for a durable symptom and disease control and possibly a favorable long term outcome.
Anil S, Lal PM, Gill DS, Beena VT. Metastasis of thyroid carcinoma to the mandible. Case report. Australian Dental Journal. 1999;44(1):56–7.
Nawale KK, Vyas M, Kane S, Patil A. Metastatic tumors in the jaw bones: A retrospective clinicopathological study of 12 cases at Tertiary Cancer Center. Journal of Oral and Maxillofacial Pathology. 2016;20(2): 252–5.
Hirshberg A, Shnaiderman-Shapiro A, Kaplan I, Berger R. Metastatic tumours to the oral cavity - Pathogenesis and analysis of 673 cases. Oral Oncology. 2008;44(8): 743–52.
Jeon YT, Kim CH, Park SM, Kim MK. Distant metastasis of follicular thyroid carcinoma to the mandible: A rare case report. Journal of the Korean Association of Oral and Maxillofacial Surgeons. 2019;45(5): 294–8.
D’Silva NJ, Summerlin DJ, Cordell KG, Abdelsayed RA, Tomich CE, Hanks CT, et al. Metastatic tumors in the jaws: A retrospective study of 114 cases. Journal of the American Dental Association [Internet]. 2006;137(12): 1667–72. Available:http://dx.doi.org/10.14219/jada.archive.2006.0112
Gholami S, Bakhshi M, Atarbashi-Moghadam S, Mir Mohammad Sadeghi H, Rahimzamani A. Mandibular metastasis of silent papillary thyroid carcinoma: A rare case report with review of the literature. Case Reports in Dentistry. 2020;2020.
Kumar RVK, Chakravarthy C, Sekhar GR, Devireddy SK, Kumaravelu C, Kare A. Metastatic thyroid carcinoma presenting as hypervascular lesion of the mandible: A case report and review of literature. Journal of Oral and Maxillofacial Surgery [Internet]. 2010;68(10):2613–6. Available:http://dx.doi.org/10.1016/j.joms.2009.10.004
Marcela Osorio, Sami P. Moubayed, Henry Su MLU. Systematic review of site distribution of bone metastases in differentiated thyroid cancer. Head and Neck. 2014;36(10): 1391.
Varadarajan VV, Pace EK, Patel V, Sawhney R, Amdur RJ, Dziegielewski PT. Follicular thyroid carcinoma metastasis to the facial skeleton: A systematic review. BMC Cancer. 2017;17(1):1–8.
Khoozestani NK, Farzaneh Mosavat, Mohammad Shirkhoda AS. Case report metastatic papillary thyroid carcinoma of the mandible: Case report and literature review. Journal of oral and Maxillofacial Pathology. 2019;23:97–105.
Ripp GA, Wendth Jr AJ, Vitale P. Metastatic thyroid carcinoma of the mandible mimicking an arteriovenous malformation. J Oral Surg. 1977;35(9): 743-5.
Guibert-Tranier F, Piton J, Riche MC, Merland JJ, Caille JM. Vascular malformations of the mandible (Intraosseous haemangiomas). The importance of preoperative embolization. A study of 9 cases. Eur J Radiol. 1982;2(4):257-72.
Kelly DE, Terry BC, Small EW. Arteriovenous malformation of the mandible: Report of case. J Oral Surg. 1977;35(5):387-93.
Mohammadi H, Said-al-Naief NA, Heffez LB. Arteriovenous malforma-tion of the mandible: Report of a case with a note on the differential diagnosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997;84(3): 286-9.
Krishnamurthy A, Deen S, Ramshankar V, Majhi U. Metastatic follicular carcinoma thyroid masquerading as a primary jaw tumor. Journal of Maxillofacial and Oral Surgery. 2016;15(2):266–9.
Most read articles by the same author(s)
- HACENE HAMMOUD, ADEL GUIDOUM, NORA MIMOUNE, RACHID KAIDI, SCALP EXPANSION FOR RECONSTRUCTION OF POSTBURN ALOPECIA IN CHILDREN: TWO CASE REPORTS , BIONATURE: 2020 - Volume 40 [Issue 3]
- Hacene Hammoud, Nora Mimoune, Adel Guidoum, Hamza Lekbir, Yacine Betam, Morsli Youcef, Ayoub Chahrour, Wassim Belferrag, Hichem Benaissa, Laurent Guyot, Mohamed Yassine Azzouz, Repair of Loss of Substances of Mandibular Ramus by a Microanastomosis of Fibula Flap: About A Case , Asian Journal of Research in Medicine and Medical Science: 2020 - Volume 2 [Issue 1]