A rare case report of metastatic breast carcinoma in the Oral mucosa and literature review
Dobromira NIKOLOVA, Spyros PAPACHARALAMBOUS, Efrosini IACOVOU, Yiola MARCOU, Nicos KATODRITIS
Private Oral and Maxillofacial Clinic Nicosia, Cyprus (Head: Dr Spyros Papacharalambous)
Hellenic Archives of Oral & Maxillofacial Surgery (2021) 1, 19-26
SUMMARY: Metastatic lesions in the oral cavity are rare, representing 1-3% of all malignant neoplasia in this region. Within this rate, there is a distribution in the literature among affected tissue, gender, and the origin of the metastases. The minority of the presented cases are describing metastatic lesions of breast cancer located in the oral cavity soft tissues in female patients.
Thus, we are presenting a case of a 47-year-old female patient who has reached the final stage of breast cancer with systematically spread metastatic disease, including lesions in the oral soft tissues. The exophytic growth of these tumors was causing difficulties in essential oral functions, such as mastication and articulation. For this reason, a palliative surgical excision of the metastases was performed, resulting in a significant improvement of the patient’s quality of life during her final palliative care treatment.
Metastatic lesions in the oral cavity are a rarity and can appear within an already known systematic disease. Furthermore, during the final stage of breast cancer, it is highly uncommon for lesions to spread in the oral mucosa; however, the latter should be considered as a pos- sible metastatic location during clinical examination and tumor staging.
KEY WORDS: metastatic breast cancer, oral metastases, oral mucosa, jawbones, palliative care
REFERENCES
Auerbach R, Lu WC, Pardon E, Gumkowski E, Kaminska G, Kaminski M: Specificity of adhesion between murine tumor cells and capil- lary endothelium; an in vitro correlate of preferential metastasis in vivo. Cancer Res. 47: 1492 – 1496, 1987
Dreizen S, Bodey GP, Rodriguez V: Oral Complications of Cancer Chemotherapy. Journal Postgraduate Medicine 58: 75 – 82, 2016 Hirshberg A, Leibovich P, Buchner A: Metastases to the oral mucosa:
analysis of 157 cases. J Oral Pathol Med 22: 385–390, 1993 Hirshberg A, Leibovich P, Buchner A: Metastatic tumors to the jaw-
bones: 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 Oncology 44: 743– 752, 2008
Hortobagyi GN, Bodey GP, Buzdar AU, Frye D, Legha SS, Malik R, Smith TR, Blumenschein GR, Yap HY, Rodriguez V: Evaluation of high-dose versus standard FAC chemotherapy for advanced breast cancer in protected environment units: a prospective ran- domized study. J Clin Oncol 5: 354–64, 1987. doi: 10.1200/JCO. 1987.5.3.354
Irani S: Metastasis to the oral soft tissues: A review of 412 cases. J Int Soc Prevent Communit Dent 6: 393–401, 2016
Kumar GS, Manjunatha BS: Metastatic tumors to the jaws and oral cav- ity. J Oral Maxillofac Pathol. 17: 71–75, 2013. doi:10.4103/0973- 029X.110737
Lester BR, McCarthy JB: Tumor cell adhesion to the extracellular matrix and signal transduction mechanisms implicated in tumor cell motil- ity, invasion and metastasis. Cancer and Metastasis Reviews 11: 31–44, 1992
Liotta L, Tryggvason K, Garbisa S, Hart I, Foltz CM, Shafie S: Metastatic potential correlates with enzymatic degradation of basement membrane collagen. Nature 284: 67–68, 1980. doi.org/10.1038/ 284067a0
Ma H, Chen M, Liu J, Li Y, Li J: Serious stomatitis and esophagitis: a pe- culiar mucous reaction induced by pegylated liposomal doxoru- bicin. An Bras Dermatol. 90: 209–211, 2015. doi:10.1590/ abd1806-4841.20153708
Mirra JM: Metastasis: Bone tumors. 1st edition Philadelphia and London: Lea & Febiger, 1495 – 1517, 1989
Müller A, Homey B, Soto H, Ge N, Catron D, Buchanan ME, McClana- han T, Murphy E, Yuan W, Wagner SN, Barrera JL, Mohar A, Verástegui E, Zlotnik A, Homey B: Involvement of chemokine receptors in breast cancer metastasis. Nature 410: 50 – 56, 2001. doi: 10.1038/35065016
Peevey L, Sumpter I, Paintal A, Laskin W, Sullivan M: SOX10 Is a Useful Marker for Triple Negative Breast Cancer. American Journal of Clinical Pathology 144: 299 – 299, 2015
Rice GE, Gimbrone Jr MA, Bevilacqua MP: Tumor Cell-Endothelial Interactions. Increased Adhesion of Human Melanoma Cells to Ac- tivated Vascular Endothelium. Am J Pathol 133: 204 – 10, 1988
Shah MY, Mehta AR: Metastasis from breast cancer presenting as an epulis in the upper gingiva. J Oral and Maxillofac Pathol. 13: 38– 40, 2009
Tozbikian GH, Zynger DL: A combination of GATA3 and SOX10 is useful for the diagnosis of metastatic triple-negative breast cancer. Hum Pathol 85:221 – 227, 2019
Van der Waal RIF, Buter J, van der Waal I: Oral metastases: report of 24 cases. British Journal of Oral and Maxillofacial Surgery 41: 3 – 6, 2003
Private Oral and Maxillofacial Clinic Nicosia, Cyprus (Head: Dr Spyros Papacharalambous)
Hellenic Archives of Oral & Maxillofacial Surgery (2021) 1, 19-26
SUMMARY: Metastatic lesions in the oral cavity are rare, representing 1-3% of all malignant neoplasia in this region. Within this rate, there is a distribution in the literature among affected tissue, gender, and the origin of the metastases. The minority of the presented cases are describing metastatic lesions of breast cancer located in the oral cavity soft tissues in female patients.
Thus, we are presenting a case of a 47-year-old female patient who has reached the final stage of breast cancer with systematically spread metastatic disease, including lesions in the oral soft tissues. The exophytic growth of these tumors was causing difficulties in essential oral functions, such as mastication and articulation. For this reason, a palliative surgical excision of the metastases was performed, resulting in a significant improvement of the patient’s quality of life during her final palliative care treatment.
Metastatic lesions in the oral cavity are a rarity and can appear within an already known systematic disease. Furthermore, during the final stage of breast cancer, it is highly uncommon for lesions to spread in the oral mucosa; however, the latter should be considered as a pos- sible metastatic location during clinical examination and tumor staging.
KEY WORDS: metastatic breast cancer, oral metastases, oral mucosa, jawbones, palliative care
REFERENCES
Auerbach R, Lu WC, Pardon E, Gumkowski E, Kaminska G, Kaminski M: Specificity of adhesion between murine tumor cells and capil- lary endothelium; an in vitro correlate of preferential metastasis in vivo. Cancer Res. 47: 1492 – 1496, 1987
Dreizen S, Bodey GP, Rodriguez V: Oral Complications of Cancer Chemotherapy. Journal Postgraduate Medicine 58: 75 – 82, 2016 Hirshberg A, Leibovich P, Buchner A: Metastases to the oral mucosa:
analysis of 157 cases. J Oral Pathol Med 22: 385–390, 1993 Hirshberg A, Leibovich P, Buchner A: Metastatic tumors to the jaw-
bones: 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 Oncology 44: 743– 752, 2008
Hortobagyi GN, Bodey GP, Buzdar AU, Frye D, Legha SS, Malik R, Smith TR, Blumenschein GR, Yap HY, Rodriguez V: Evaluation of high-dose versus standard FAC chemotherapy for advanced breast cancer in protected environment units: a prospective ran- domized study. J Clin Oncol 5: 354–64, 1987. doi: 10.1200/JCO. 1987.5.3.354
Irani S: Metastasis to the oral soft tissues: A review of 412 cases. J Int Soc Prevent Communit Dent 6: 393–401, 2016
Kumar GS, Manjunatha BS: Metastatic tumors to the jaws and oral cav- ity. J Oral Maxillofac Pathol. 17: 71–75, 2013. doi:10.4103/0973- 029X.110737
Lester BR, McCarthy JB: Tumor cell adhesion to the extracellular matrix and signal transduction mechanisms implicated in tumor cell motil- ity, invasion and metastasis. Cancer and Metastasis Reviews 11: 31–44, 1992
Liotta L, Tryggvason K, Garbisa S, Hart I, Foltz CM, Shafie S: Metastatic potential correlates with enzymatic degradation of basement membrane collagen. Nature 284: 67–68, 1980. doi.org/10.1038/ 284067a0
Ma H, Chen M, Liu J, Li Y, Li J: Serious stomatitis and esophagitis: a pe- culiar mucous reaction induced by pegylated liposomal doxoru- bicin. An Bras Dermatol. 90: 209–211, 2015. doi:10.1590/ abd1806-4841.20153708
Mirra JM: Metastasis: Bone tumors. 1st edition Philadelphia and London: Lea & Febiger, 1495 – 1517, 1989
Müller A, Homey B, Soto H, Ge N, Catron D, Buchanan ME, McClana- han T, Murphy E, Yuan W, Wagner SN, Barrera JL, Mohar A, Verástegui E, Zlotnik A, Homey B: Involvement of chemokine receptors in breast cancer metastasis. Nature 410: 50 – 56, 2001. doi: 10.1038/35065016
Peevey L, Sumpter I, Paintal A, Laskin W, Sullivan M: SOX10 Is a Useful Marker for Triple Negative Breast Cancer. American Journal of Clinical Pathology 144: 299 – 299, 2015
Rice GE, Gimbrone Jr MA, Bevilacqua MP: Tumor Cell-Endothelial Interactions. Increased Adhesion of Human Melanoma Cells to Ac- tivated Vascular Endothelium. Am J Pathol 133: 204 – 10, 1988
Shah MY, Mehta AR: Metastasis from breast cancer presenting as an epulis in the upper gingiva. J Oral and Maxillofac Pathol. 13: 38– 40, 2009
Tozbikian GH, Zynger DL: A combination of GATA3 and SOX10 is useful for the diagnosis of metastatic triple-negative breast cancer. Hum Pathol 85:221 – 227, 2019
Van der Waal RIF, Buter J, van der Waal I: Oral metastases: report of 24 cases. British Journal of Oral and Maxillofacial Surgery 41: 3 – 6, 2003
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