Mandibular metastasis of a papillary thyroid carcinoma, tall cell variant. Case
report and review of the literature
Kimberly PINGEL, Eleni-Marina KALOGIROU, Ioannis G. KOUTLAS, Konstantinos I. TOSIOS
Division of Oral and Maxillofacial Surgery and Division of Oral and Maxillofacial Pathology (Director: JA Swift), School of Dentistry, University of Minnesota, Minneapolis, MN, USA and Department of Oral Pathology (Head: Professor A. Sklavounou), Dental School, University of Athens, Greece.
Hellenic Archives of Oral & Maxillofacial Surgery (2013) 3, 143-152
SUMMARY: We present the unusual case of a 76-yearold man with a history of tall cell variant of papillary thyroid carcinoma, presenting with a painless and easily bleeding swelling posterior to the second mandibular molar tooth, initially considered as a periodontal or tooth infection. Radiographic examination revealed a unilocular radiolucency in the left posterior mandible and I 131 bone scan showed hot spots suggestive of a thyroid metastatic carcinoma to the posterior left mandible, the ribs and the left clavicle. Microscopic examination showed metastatic tall cell variant of papillary thyroid carcinoma. The patient was given radiation treatment, but 11 months later, approximately 8 years after the initial diagnosis of thyroid carcinoma, he died of his disease. A Medline search of the English literature from 1965 to December 2012 yielded 59 cases of metastatic thyroid carcinoma to the oral cavity and jaws, where the oral site of metastasis was specified and there was histologic confirmation.
KEY WORDS: mandible; oral metastasis; thyroid gland; papillary thyroid carcinoma
REFERENCES
Agarwal A, Mishra SK, Jain M: Follicular thyroid carcinoma with metastasis to the mandible. J Indian Med Assoc 96:354-355, 1998
Al-Ani S: Metastatic tumors to the mouth: Report of two cases. J Oral Surg 31:120-122, 1973
Algahtani M, Alqudah M, Alshehri S, Binahmed A, Sándor GK: Pathologic fracture of the mandible caused by metastatic follicular thyroid carcinoma. J Can Dent Assoc 75:457-60, 2009
Anil S, Lal PM, Gill DS, Beena VT: Metastasis of thyroid carcinoma to the mandible. Case report. Austr Dental J 44:56-57, 1999
Antunes AA, Antunes AP: Gnathic bone metastasis: A retrospective study of 10 cases. Rev Bras Otorrinolaringol 74:561-565, 2008
Araki M, Nishimura S, Iwanari S, Sawada A, Matsumoto N, Honda K, Ohki H, Komiyama K: Mandibular metastases from follicular carcinoma of the thyroid gland: A case report. Oral Radiol 24:85– 89, 2008
Baloch ZW, LiVolsi VA: Encapsulated follicular variant of papillary thyroid carcinoma with bone metastases. Mod Pathol 13:861-865, 2000
Bhadage CJ, Vaishampayan S, Umarji H: Mandibular metastasis in a patient with follicular carcinoma of thyroid. Contemp Clin Dent 3:212-214, 2012
Bhansali A, Kataria RN, Subrahmanyam KAV, Radotra BD, Mathur SK: Maxillary Mass as the Presenting Manifestation of Papillary Thyroid Carcinoma. Indian J Cancer 40:80-81, 2003
Bhaskar SN: Oral manifestations of metastatic tumors. Postgrad Med 49:155-158, 1971
Bodner L, Sion-Vardy N, Geffen DB, Nash M: Metastatic tumors to the jaws: A report of eight new cases. Med Oral Patol Oral Cir Bucal 11:132-135, 2006 Buchner A, Ramon Y: Distant metastases to the jaws: Report of four cases. J Oral Surg 25:246-250, 1967
Chaturvedy G, Kumar R, Sikka K, Karthikeyan CV, Mathur SR: An unusual site of distant metastasis in carcinoma of the thyroid. Indian J Cancer 47:479-480, 2010
Clausen F, Poulsen H: Metastatic carcinoma of the jaws. Acta Pathol Microbiol Scand 57:361-374, 1963
Colella G, Capone R, Cappabianca S: Mandibular metastasis from papillary thyroid carcinoma--a case report. Tumori 89:452-454, 2003
Daley T, Darling M: Metastases to the mouth and jaws: A contemporary Canadian experience. J Can Dent Assoc 77:67-73, 2011
Draper BW, Precious DS, Priddy RW, Byrd DL: Clinicopathological conference. Case 29, part 2. Follicular thyroid carcinoma metastatic to the mandible. J Oral Surg 37:736-739, 1979
D'Silva NJ, Summerlin DJ, Cordell KG, Abdelsayed RA, Tomich CE, Hanks CT, Fear D, Meyrowitz S: Metastatic tumors in the jaws: A retrospective study of 114 cases. J Am Dent Assoc 137:1667-1672, 2006
Erdag T, Bilgen C, Ceryan K: Metastatic thyroid carcinoma of the mandible. Rev Laryngol Otol Rhinol (Bord) 120:31-34, 1999
Hedinger C, Williams ED, Sobin LH: Histological typing of thyroid tumours, In: World Health Organization. Springer Verlag, Berlin, 1988, pp 9-11
Hefer T, Manor R, Joachims HZ, Groisman GM, Peled M, Gov-Ari E, Laufer D: Metastatic follicular thyroid carcinoma to the maxilla. J Laryngol Otol 112:69-72, 1998
Hirshberg A, Buchner A: Metastatic tumours to the oral region. An overview. Eur J Cancer B Oral Oncol 31:355-360, 1995
Hirshberg A, Leibovich P, Buchner A: Metastatic tumors to the jawbones: Analysis of 390 cases. J Oral Pathol Med 23:337-341, 1994
Hirshberg A, Shnaiderman-Shapiro A, Kaplan I, Berger R: Metastatic tumours to the oral cavity –Pathogenesis and analysis of 673 cases. Oral Oncol 44:743– 752, 2008
Ismail SB, Abraham MT, Zaini ZB, Yaacob HB, Zain RB: Metastatic follicular thyroid carcinoma to the mandible: A case report. Cases J 2:6533-6535, 2009 Kahn MA, McCord PT: Metastatic thyroid carcinoma of the mandible: Case report. J Oral Maxillofac Surg 47:1314-1316, 1989
Kaveri H, Punnya VA, Tayaar Amsavardani S: Metastatic thyroid carcinoma to the mandible. J Oral Maxillofac Pathol 11:32-4, 2007
Kim D-W, Hun Hah J, An S-Y, Chang H, Kim KH: Follicular Thyroid Carcinoma Presenting as Bilateral Cheek Masses. Clin Exp Otorhinolaryngol 4:13-16, 2011 Kumar KRV, 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. J Oral Maxillofac Surg 68:2613-2616, 2010
Liu L, Venkataraman G, Salhadar A: Follicular variant of papillary thyroid carcinoma with unusual late metastasis to the mandible and the scapula. Pathol Int 57:296–298, 2007άνου 1996: σελ. 3-13
LiVolsi VA: Papillary thyroid carcinoma: an update. Mod Pathol 24:1- 9, 2011
Markitziu A, Fisher D, Marmary Y: Thyroid papillary carcinoma presenting as jaw and parotid gland metastases. Int J Oral Maxillofac Surg 15:648-653, 1986 McDaniel RK, Luna MA, Stimson PG: Metastatic tumours in the jaws. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 31:380-386, 1971
Meyer I, Shklar G: Malignant turnouts metastatic to mouth and jaws. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 20:350-362, 1965
Muttagi SS, Chaturvedi P, D'Cruz A, Kane S, Chaukar D, Pai P, Singh B, Pawar P: Metastatic tumors to the jaw bones: retrospective analysis from an Indian tertiary referral center. Indian J Cancer 48:234-239, 2011
Nikitakis NG, Polymeri A, Polymeris A, Sklavounou A: Metastatic Papillary Thyroid Carcinoma to the Maxilla: Case Report and Literature Review. Head Neck Pathol 6:213-223, 2012
Nishikawa H, Nakashiro K, Sumida T, Sugita A, Hamakawa H: Mandibular osteoblastic metastasis of poorly differentiated carcinoma of the thyroid gland. Int J Oral Maxillofac Surg 39:292–307, 2010
Nishimura Y, Nakajima T, Yakata H, Kawasaki T, Fukushima M: Metastatic thyroid carcinoma of the mandible. J Oral Maxillofac Surg 40:221-225, 1982 Osguthorpe JD, Bratton JR: Occult thyroid carcinoma appearing as a single mandibular metastasis. Otolaryngol Head Neck Surg 90:674-675, 1982
Ostrosky A, Mareso EA, Klurfan FJ, Gonzalez MJ: Mandibular metastasis of follicular thyroid carcinoma. Case report. Med Oral 8:224-227, 2003 Parichatikanond P, Parichatikanond P, Damrongvadha P, Kompairoj C, Chaovanapricha K: Jaw metastasis from follicular carcinoma of thyroid gland simulating ameloblastoma. J Med Assoc Thai 67:362- 367, 1984
Piattelli A, Fioroni M, Rubini C: Gingival Metastasis From a Medullary Thyroid Carcinoma: Case Report. J Periodontol 71:112-116, 2000
Ripp GA, Wendth AJ Jr, Vitale P: Metastatic thyroid carcinoma of the mandible mimicking an arteriovenous malformation. J Oral Surg 35:743-745, 1977 Seoane J, Van der Waal I, Van der Waal RIF, Cameselle-Teijeiro J, Anton I, Tardio A, Alca´zar-Otero JJ, Varela-Centelles P, Diz P: Metastatic tumours to the oral cavity: A survival study with a special focus on gingival metastases. J Clin Periodontol 36:488–492, 2009
Shabestari SB, Shirinbak I, Agha-Hosseini F: Maxillary Metastasis of a Medullary Thyroid Carcinoma in a 21-year-old Woman 7 years After Thyroidectomy. J Oral Maxillofac Surg 2011 PMID: 21978719
Soumar J, Haisova L, Hanek P: Rare localization of a thyroid cancer metastasis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 29:513-517, 1970 Stypulkowska J, Bartkowski S, Pana's M, Zaleska M: Metastatic tumors to the jaws and oral cavity. J Oral Surg 37:805-808, 1979
Tamiolakis D, Tsamis I, Thomaidis V, Lambropoulou M, Alexiadis G, Venizelos I, Jivanakis T, Papadopoulos N: Jaw bone metastases: Four cases. Acta Dermatoven Alp Panonica Adriat 16:21-15, 2007
Thomas G, Sreelatha KT, Pradeep VM, Pandey M: Follicular Carcinoma of the Thyroid Gland With Initial Presentation as an Oral Soft Tissue Mass: Report of a Case. J Oral Maxillofac Surg 59:819-822, 2001
Tickoo SK, Pittas AG, Adler M, Fazzari M, Larson SM, Robbins RJ, Rosai J: Bone metastases from thyroid carcinoma: a histopathologic study with clinical correlates. Arch Pathol Lab Med 124:1440- 1447, 2000
Toubert ME, Hindie E, Rampin L, Al-Nahhas A, Rubello D: Distant metastases of differentiated thyroid cancer: Diagnosis, treatment and outcome. Nucl Med Rev Cent East Eur 10:106-109, 2007
Tovi F, Leiberman A, Hirsch M: Uncommon clinical manifestations in a case of thyroid carcinoma. Head Neck Surg 6:974-977, 1984
Vural E, Hanna E: Metastatic follicular thyroid carcinoma to the mandible: A case report and review of the literature. Am J Otolaryngol 19:198-202, 1998 Whitaker B, Robinson K, Hewan-Lowe K, Budnick S: Thyroid metastasis to the oral soft tissues: Case report of a diagnostic dilemma. J Oral Maxillofac Surg 51:588-593, 1993
Yokoe H, Kasamatsu A, Ogoshi K, Ogawara K, Endo-Sakamoto Y, Ono K, Shiiba M., Uzawa K, Sato Y, Tanzawa, H: Mandibular metastasis from thyroid follicular carcinoma: A case report. Asian J Oral Maxillofac Surg 22:208-211, 2010
Zachariades N: Neoplasms metastatic to the mouth, jaws and surrounding tissues. J Craniomaxillofac Surg 17:283-290, 1989
Division of Oral and Maxillofacial Surgery and Division of Oral and Maxillofacial Pathology (Director: JA Swift), School of Dentistry, University of Minnesota, Minneapolis, MN, USA and Department of Oral Pathology (Head: Professor A. Sklavounou), Dental School, University of Athens, Greece.
Hellenic Archives of Oral & Maxillofacial Surgery (2013) 3, 143-152
SUMMARY: We present the unusual case of a 76-yearold man with a history of tall cell variant of papillary thyroid carcinoma, presenting with a painless and easily bleeding swelling posterior to the second mandibular molar tooth, initially considered as a periodontal or tooth infection. Radiographic examination revealed a unilocular radiolucency in the left posterior mandible and I 131 bone scan showed hot spots suggestive of a thyroid metastatic carcinoma to the posterior left mandible, the ribs and the left clavicle. Microscopic examination showed metastatic tall cell variant of papillary thyroid carcinoma. The patient was given radiation treatment, but 11 months later, approximately 8 years after the initial diagnosis of thyroid carcinoma, he died of his disease. A Medline search of the English literature from 1965 to December 2012 yielded 59 cases of metastatic thyroid carcinoma to the oral cavity and jaws, where the oral site of metastasis was specified and there was histologic confirmation.
KEY WORDS: mandible; oral metastasis; thyroid gland; papillary thyroid carcinoma
REFERENCES
Agarwal A, Mishra SK, Jain M: Follicular thyroid carcinoma with metastasis to the mandible. J Indian Med Assoc 96:354-355, 1998
Al-Ani S: Metastatic tumors to the mouth: Report of two cases. J Oral Surg 31:120-122, 1973
Algahtani M, Alqudah M, Alshehri S, Binahmed A, Sándor GK: Pathologic fracture of the mandible caused by metastatic follicular thyroid carcinoma. J Can Dent Assoc 75:457-60, 2009
Anil S, Lal PM, Gill DS, Beena VT: Metastasis of thyroid carcinoma to the mandible. Case report. Austr Dental J 44:56-57, 1999
Antunes AA, Antunes AP: Gnathic bone metastasis: A retrospective study of 10 cases. Rev Bras Otorrinolaringol 74:561-565, 2008
Araki M, Nishimura S, Iwanari S, Sawada A, Matsumoto N, Honda K, Ohki H, Komiyama K: Mandibular metastases from follicular carcinoma of the thyroid gland: A case report. Oral Radiol 24:85– 89, 2008
Baloch ZW, LiVolsi VA: Encapsulated follicular variant of papillary thyroid carcinoma with bone metastases. Mod Pathol 13:861-865, 2000
Bhadage CJ, Vaishampayan S, Umarji H: Mandibular metastasis in a patient with follicular carcinoma of thyroid. Contemp Clin Dent 3:212-214, 2012
Bhansali A, Kataria RN, Subrahmanyam KAV, Radotra BD, Mathur SK: Maxillary Mass as the Presenting Manifestation of Papillary Thyroid Carcinoma. Indian J Cancer 40:80-81, 2003
Bhaskar SN: Oral manifestations of metastatic tumors. Postgrad Med 49:155-158, 1971
Bodner L, Sion-Vardy N, Geffen DB, Nash M: Metastatic tumors to the jaws: A report of eight new cases. Med Oral Patol Oral Cir Bucal 11:132-135, 2006 Buchner A, Ramon Y: Distant metastases to the jaws: Report of four cases. J Oral Surg 25:246-250, 1967
Chaturvedy G, Kumar R, Sikka K, Karthikeyan CV, Mathur SR: An unusual site of distant metastasis in carcinoma of the thyroid. Indian J Cancer 47:479-480, 2010
Clausen F, Poulsen H: Metastatic carcinoma of the jaws. Acta Pathol Microbiol Scand 57:361-374, 1963
Colella G, Capone R, Cappabianca S: Mandibular metastasis from papillary thyroid carcinoma--a case report. Tumori 89:452-454, 2003
Daley T, Darling M: Metastases to the mouth and jaws: A contemporary Canadian experience. J Can Dent Assoc 77:67-73, 2011
Draper BW, Precious DS, Priddy RW, Byrd DL: Clinicopathological conference. Case 29, part 2. Follicular thyroid carcinoma metastatic to the mandible. J Oral Surg 37:736-739, 1979
D'Silva NJ, Summerlin DJ, Cordell KG, Abdelsayed RA, Tomich CE, Hanks CT, Fear D, Meyrowitz S: Metastatic tumors in the jaws: A retrospective study of 114 cases. J Am Dent Assoc 137:1667-1672, 2006
Erdag T, Bilgen C, Ceryan K: Metastatic thyroid carcinoma of the mandible. Rev Laryngol Otol Rhinol (Bord) 120:31-34, 1999
Hedinger C, Williams ED, Sobin LH: Histological typing of thyroid tumours, In: World Health Organization. Springer Verlag, Berlin, 1988, pp 9-11
Hefer T, Manor R, Joachims HZ, Groisman GM, Peled M, Gov-Ari E, Laufer D: Metastatic follicular thyroid carcinoma to the maxilla. J Laryngol Otol 112:69-72, 1998
Hirshberg A, Buchner A: Metastatic tumours to the oral region. An overview. Eur J Cancer B Oral Oncol 31:355-360, 1995
Hirshberg A, Leibovich P, Buchner A: Metastatic tumors to the jawbones: Analysis of 390 cases. J Oral Pathol Med 23:337-341, 1994
Hirshberg A, Shnaiderman-Shapiro A, Kaplan I, Berger R: Metastatic tumours to the oral cavity –Pathogenesis and analysis of 673 cases. Oral Oncol 44:743– 752, 2008
Ismail SB, Abraham MT, Zaini ZB, Yaacob HB, Zain RB: Metastatic follicular thyroid carcinoma to the mandible: A case report. Cases J 2:6533-6535, 2009 Kahn MA, McCord PT: Metastatic thyroid carcinoma of the mandible: Case report. J Oral Maxillofac Surg 47:1314-1316, 1989
Kaveri H, Punnya VA, Tayaar Amsavardani S: Metastatic thyroid carcinoma to the mandible. J Oral Maxillofac Pathol 11:32-4, 2007
Kim D-W, Hun Hah J, An S-Y, Chang H, Kim KH: Follicular Thyroid Carcinoma Presenting as Bilateral Cheek Masses. Clin Exp Otorhinolaryngol 4:13-16, 2011 Kumar KRV, 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. J Oral Maxillofac Surg 68:2613-2616, 2010
Liu L, Venkataraman G, Salhadar A: Follicular variant of papillary thyroid carcinoma with unusual late metastasis to the mandible and the scapula. Pathol Int 57:296–298, 2007άνου 1996: σελ. 3-13
LiVolsi VA: Papillary thyroid carcinoma: an update. Mod Pathol 24:1- 9, 2011
Markitziu A, Fisher D, Marmary Y: Thyroid papillary carcinoma presenting as jaw and parotid gland metastases. Int J Oral Maxillofac Surg 15:648-653, 1986 McDaniel RK, Luna MA, Stimson PG: Metastatic tumours in the jaws. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 31:380-386, 1971
Meyer I, Shklar G: Malignant turnouts metastatic to mouth and jaws. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 20:350-362, 1965
Muttagi SS, Chaturvedi P, D'Cruz A, Kane S, Chaukar D, Pai P, Singh B, Pawar P: Metastatic tumors to the jaw bones: retrospective analysis from an Indian tertiary referral center. Indian J Cancer 48:234-239, 2011
Nikitakis NG, Polymeri A, Polymeris A, Sklavounou A: Metastatic Papillary Thyroid Carcinoma to the Maxilla: Case Report and Literature Review. Head Neck Pathol 6:213-223, 2012
Nishikawa H, Nakashiro K, Sumida T, Sugita A, Hamakawa H: Mandibular osteoblastic metastasis of poorly differentiated carcinoma of the thyroid gland. Int J Oral Maxillofac Surg 39:292–307, 2010
Nishimura Y, Nakajima T, Yakata H, Kawasaki T, Fukushima M: Metastatic thyroid carcinoma of the mandible. J Oral Maxillofac Surg 40:221-225, 1982 Osguthorpe JD, Bratton JR: Occult thyroid carcinoma appearing as a single mandibular metastasis. Otolaryngol Head Neck Surg 90:674-675, 1982
Ostrosky A, Mareso EA, Klurfan FJ, Gonzalez MJ: Mandibular metastasis of follicular thyroid carcinoma. Case report. Med Oral 8:224-227, 2003 Parichatikanond P, Parichatikanond P, Damrongvadha P, Kompairoj C, Chaovanapricha K: Jaw metastasis from follicular carcinoma of thyroid gland simulating ameloblastoma. J Med Assoc Thai 67:362- 367, 1984
Piattelli A, Fioroni M, Rubini C: Gingival Metastasis From a Medullary Thyroid Carcinoma: Case Report. J Periodontol 71:112-116, 2000
Ripp GA, Wendth AJ Jr, Vitale P: Metastatic thyroid carcinoma of the mandible mimicking an arteriovenous malformation. J Oral Surg 35:743-745, 1977 Seoane J, Van der Waal I, Van der Waal RIF, Cameselle-Teijeiro J, Anton I, Tardio A, Alca´zar-Otero JJ, Varela-Centelles P, Diz P: Metastatic tumours to the oral cavity: A survival study with a special focus on gingival metastases. J Clin Periodontol 36:488–492, 2009
Shabestari SB, Shirinbak I, Agha-Hosseini F: Maxillary Metastasis of a Medullary Thyroid Carcinoma in a 21-year-old Woman 7 years After Thyroidectomy. J Oral Maxillofac Surg 2011 PMID: 21978719
Soumar J, Haisova L, Hanek P: Rare localization of a thyroid cancer metastasis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 29:513-517, 1970 Stypulkowska J, Bartkowski S, Pana's M, Zaleska M: Metastatic tumors to the jaws and oral cavity. J Oral Surg 37:805-808, 1979
Tamiolakis D, Tsamis I, Thomaidis V, Lambropoulou M, Alexiadis G, Venizelos I, Jivanakis T, Papadopoulos N: Jaw bone metastases: Four cases. Acta Dermatoven Alp Panonica Adriat 16:21-15, 2007
Thomas G, Sreelatha KT, Pradeep VM, Pandey M: Follicular Carcinoma of the Thyroid Gland With Initial Presentation as an Oral Soft Tissue Mass: Report of a Case. J Oral Maxillofac Surg 59:819-822, 2001
Tickoo SK, Pittas AG, Adler M, Fazzari M, Larson SM, Robbins RJ, Rosai J: Bone metastases from thyroid carcinoma: a histopathologic study with clinical correlates. Arch Pathol Lab Med 124:1440- 1447, 2000
Toubert ME, Hindie E, Rampin L, Al-Nahhas A, Rubello D: Distant metastases of differentiated thyroid cancer: Diagnosis, treatment and outcome. Nucl Med Rev Cent East Eur 10:106-109, 2007
Tovi F, Leiberman A, Hirsch M: Uncommon clinical manifestations in a case of thyroid carcinoma. Head Neck Surg 6:974-977, 1984
Vural E, Hanna E: Metastatic follicular thyroid carcinoma to the mandible: A case report and review of the literature. Am J Otolaryngol 19:198-202, 1998 Whitaker B, Robinson K, Hewan-Lowe K, Budnick S: Thyroid metastasis to the oral soft tissues: Case report of a diagnostic dilemma. J Oral Maxillofac Surg 51:588-593, 1993
Yokoe H, Kasamatsu A, Ogoshi K, Ogawara K, Endo-Sakamoto Y, Ono K, Shiiba M., Uzawa K, Sato Y, Tanzawa, H: Mandibular metastasis from thyroid follicular carcinoma: A case report. Asian J Oral Maxillofac Surg 22:208-211, 2010
Zachariades N: Neoplasms metastatic to the mouth, jaws and surrounding tissues. J Craniomaxillofac Surg 17:283-290, 1989
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