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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Oral and maxillofacial pain as the first sign of metastasis of an occult primary tumour: A fifteen-year retrospective study
Shan Shan, Shu Liu, Zhen-Yu Yang, Tie-Mei Wang, Zi-Tong Lin, Ying-Lian Feng, Seyiti Pakezhati, Xiao-Feng Huang, Lei Zhang, Guo-Wen Sun
Shan Shan, Shu Liu, Zhen-Yu Yang, Tie-Mei Wang, Zi-Tong Lin, Ying-Lian Feng, Seyiti Pakezhati, Department of Dentomaxillofacial Radiology, The Affiliated Stomatology Hospital of Medical School, Nanjing University, Nanjing 210008, Jiangsu Province, China
Xiao-Feng Huang, Lei Zhang, Department of Oral Pathology,The Affiliated Stomatology Hospital of Medical School, Nanjing University, Nanjing 210008, Jiangsu Province, China
Guo-Wen Sun, Department of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Medical School, Nanjing University, Nanjing 210008, Jiangsu Province, China
Author contributions: Wang TM contributed to the conception of the work, manuscript editing and integrity of any part of the work; Shan S designed the research study and wrote the manuscript; Liu S, Yang ZY, Lin ZT and Feng YL performed the research; Pakezhati S, Huang XF, Zhang L and Sun GW analyzed the data; all authors have read and approve the final manuscript.
Supported by the Jiangsu Province Natural Science Foundation of China, No. BK20150089; and the Nanjing Science and Technology Development Fund, No. 201503038.
Institutional review board statement: This study was reviewed and approved by the Nanjing Stomatological Hospital Medical School of Nanjing University.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the Authors have no conflict of interest related to the manuscript.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Tie-Mei Wang, PhD, Chief Physician, Department of Dentomaxillofacial Radiology, The Affiliated Stomatology Hospital of Medical School, Nanjing University, No. 30 Zhongyang Road, Nanjing 210008, Jiangsu Province, China. tiemei106@126.com
Received: November 16, 2021
Peer-review started: November 16, 2021
First decision: December 27, 2021
Revised: January 5, 2022
Accepted: March 16, 2022
Article in press: March 16, 2022
Published online: May 16, 2022
ARTICLE HIGHLIGHTS
Research background
Metastatic adenocarcinoma of the jaw (MAJ) is a rare disease that accounts for 1%-3% of all oral and maxillofacial malignant tumours. To date, few studies have focused on the diversity of imaging features, and no study has classified the computed tomography (CT) findings of MAJ.
Research motivation
Oral and maxillofacial pain may be the first symptom of metastatic spread of an occult primary tumour. Therefore, early identification of oral and maxillofacial pain by dental professionals is important.
Research objectives
To explore the clinical and CT features of MAJ with oral and maxillofacial pain as the first symptom.
Research methods
Fourteen cases of MAJ from 2006 to 2020 in our hospital were collected, and clinical and the CT features were analysed retrospectively.
Research results
MAJ occurs predominantly in middle-aged and elderly men, with the most common site being the posterior mandible. MAJ is marked by numb chin syndrome (NCS), as well as rapidly progressive osteolytic bone destruction with periosteal reaction and a localised soft tissue mass, usually without jaw expansion on CT.
Research conclusions
MAJ has complex clinical and CT features. Oral and maxillofacial pain may be the first sign of a primary tumour affecting other sites. When middle-aged and elderly patients present with NCS, and CT images reveal rapidly progressive osteolytic bone destruction with moth-eaten and permeative margins, clinicians should be aware of the possibility of MAJ and attempt to identify the primary lesion early to improve survival.
Research perspectives
Further studies with larger sample sizes are required to confirm our results.
