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Metastatic Tumors to the Oral Soft Tissues and Jawbones: A Retrospective Analysis of 40 Cases and Review of the Literature

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Abstract

Background

Metastasis to the oral soft tissues and jawbones is rare and frequently associated with wide spread disease and dismal prognosis. Herein, we report the clinicopathologic characteristics of 40 intraoral metastatic neoplasms and perform a comprehensive review of the pertinent literature.

Methods

Criteria for inclusion included: (a) archived cases from the UMN Oral Pathology laboratory with available tissue blocks and/or H&E-stained preparations diagnosed between 2003 and 2021, (b) proper documentation of the clinico-radiographic characteristics of oral metastasis along with confirmed history of primary malignancy, or (c) microscopic findings consistent with metastatic disease with or without discovery of the primary site.

Results

Intraoral metastases comprised 0.03% of all accessioned cases; 22 (55%) occurred in men and 18 (45%) in women (median age = 66.5; range = 18–94 years). Eighteen cases (45%) involved the gingiva, 16 (40%) the gingiva and jawbones, 5 (12.5%) were exclusively intraosseous, and 1 affected (2.5%) the tongue. The lung was the two most frequent primary site in both men (n = 6, 27.3%) and women (n = 5, 27.7%), followed by the colon (n = 4, 18.2%) and kidney (n = 3, 13.7%) in men, and colon (n = 4, 22.2%) and breast (n = 3, 16.6%) in women. Analysis of 1,084 metastatic cases from the literature (male-to-female ratio = 1.2; mean = 52.3; range = 0.6–90 years) indicated strong preference for the jawbones (69.5%) and significant site-specific predilection of certain primary malignancies.

Conclusions

Oral and gnathic metastases are rare but demonstrate a clear predilection for the gingiva and mandible. Clinicians should remain cognizant of such lesions since they frequently mimic inflammatory, reactive or benign neoplastic processes and, in certain cases, are the first indication of occult disease.

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Data Availability

The data and material presented in this study are available upon request.

Code Availability

Not applicable.

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Authors and Affiliations

  1. School of Dentistry, University of Minnesota, Minneapolis, MN, USA

    Dan P. Ho & Peter E. Wilkinson

  2. Department of Obstetrics, Gynecology and Women’s Health, University of Minnesota, Minneapolis, MN, USA

    Rachel I. Vogel

  3. Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA

    Rachel I. Vogel & Prokopios P. Argyris

  4. Division of Oral and Maxillofacial Pathology, School of Dentistry, University of Minnesota, 515 Delaware Street SE 16-206B, Minneapolis, MN, 55455, USA

    Rajaram Gopalakrishnan & Prokopios P. Argyris

  5. Department of Biochemistry, Molecular Biology and Biophysics, University of Minnesota, Minneapolis, MN, USA

    Prokopios P. Argyris

  6. Institute for Molecular Virology, University of Minnesota, Minneapolis, MN, USA

    Prokopios P. Argyris

  7. Center for Genome Engineering, University of Minnesota, Minneapolis, MN, USA

    Prokopios P. Argyris

  8. Howard Hughes Medical Institute, University of Minnesota, Minneapolis, MN, USA

    Prokopios P. Argyris

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  1. Dan P. Ho
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Contributions

Conceptualization and design of the study was performed by RG and PPA. Material preparation, data collection and analysis were performed by DPH, PEW, RG and PPA. Statistical analyses were performed by RIV. The first draft of the manuscript was written by DPH and PPA. All authors commented on previous versions of the manuscript and have read and approved the final submitted version of the manuscript.

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Correspondence to Prokopios P. Argyris.

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Ho, D.P., Wilkinson, P.E., Vogel, R.I. et al. Metastatic Tumors to the Oral Soft Tissues and Jawbones: A Retrospective Analysis of 40 Cases and Review of the Literature. Head and Neck Pathol 16, 802–813 (2022). https://doi.org/10.1007/s12105-022-01451-8

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