Unique and rare bone metastases from occult primary cancer.

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COD: 289-296 Categorie: ,

Maria Giulia Cristofaro, Amerigo Giudice, Walter Colangeli, Mario Giudice

Ann. Ital. Chir., 2011 82: 289-296

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AIM: The airn of our study is to describe the rare location of metastasis cancers (kidney and prostate) in the jaw bones
(maxillary branch and the condyle); this is the first and the only sign of disease.
MATERIAL OF STUDY: Two patients referred to us for a swelling in his left preauricolar region with a moderate pain.
They underwent a radiologic and bioptic examinations that showed a metastasis which could arise from a primary prostatic
and renal adenocarcinoma. The patients underwent surgical treatment (Subtotal-emimandibulectomy and reconstruction
with metallic endoprosthesis).
RESULTS: The final follow up for the first patient was acceptable and without any motor or sensory deficit. The patient
also underwent chemotherapy for his primary tumour and radiotherapy of his mandibular condyle metastasis during the
preoperative stage.
The final follow-up of the second patient was performer two years after the surgery and it did not show any recurrence
and after about 18 months from surgery has performed dentistry rehabilitation. The patient had a chemotherapy treatment
with the administration of bisphosphonates for the presence of skeletal metastases.
DISCUSSION AND CONCLUSION: Just 1% of carcinomas metastasizes in jaw bones. The low rate is linked to the low active
bone marrow content in jaw bones of adult patients. For the prostatic and breast adenocarcinomas the neoplastic
embolis reaches the skeleton directly, passing through the vertebral venous system (Batson’s hypothesis). Early diagnosis
made the treatment both of the primary tumour and of its recurrence (single metastasis) more effective.

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