Oral and maxillary metastasesretrospective clinical analysis of 21 cases

Abstract

Objective: Retrospective descriptive study of 21 oral soft tissue and/or maxillary bone metastatic cases. Materials and methods: Hospital records of our own department are reviewed for a 12-year period. Lymphoproliferative diseases, skin metastases, salivary glands, other craniofacial bones and cervical lymph-nodes are excluded. Epidemiologic, personal health, clinical, treatment and follow-up data are recollected and analysed in frequency statistics. Results: Male:Female ratio is 1.3:1, year-old range 52-82 and ethnic group 100 % white-caucasian. 19.0 % have carcinogenic occupational exposure, 52.4 % tobacco abuse, 61.9 % some kind of alcohol use, 57.1 % cardiovascular risk, 19.0 % cardiologic records, 28.6 % pulmonary, 19.0 % gastrointestinal, 19.0 % endocrine, 14.3 % genitourinary, 9.5 % other primary malignancy and 23.8% a first-degree relative with a neoplasm. 33.3 % patients have taken osteonecrosis-related drugs or received craniofacial radiotherapy. Metastasis is the debut in 7 patients while it corresponds to infirmity progression in 14. The chief reason for consultation is a mass. 8 lesions affect soft tissue and 13 the bone. 81.0 % have epithelial neoplasm lineages. The organ of origin is: 23.8 % lung, 23.8 breast, 23.8 % kidney, 9.5 % skin, 9.5 % soft parts, 4.8 % prostate and 4.8 % thyroid. 100 % have other location metastases. 14.3 % patients undergo surgery, 38.1 % receive radiotherapy, 47.6 % chemo- or targeted therapy, and 28.6 % symptomatic treatment. After a 1-124 months range of follow-up, 17 patients die and 4 are alive. Conclusions: Craniomaxillofacial metastases, usually with multiple visceral or axial skeleton lesions, have an ominous prognosis. Multidisciplinary management could benefit the patient status and lead to more favourable outcomes. There are exceptional cases of long-term survival.