Metastatic solid tumors to the jaw and oral soft tissue: A retrospective clinical analysis of 44 patients from a single institution.
OBJECTIVE
Metastatic solid tumors to the oral cavity are rare, frequently indicative of an end-stage disease process, and associated with poor survival rates. We performed a 20-year retrospective clinical analysis of our institution's cases of solid metastases to the oral cavity, and investigated these patients' clinical outcomes.


METHODS
A retrospective study of patients with metastatic solid tumors to the oral cavity over a 20-year period (October 1996 to September 2015) was conducted at Memorial Sloan Kettering Cancer Center. Patients were selected if they had a histopathologically confirmed diagnosis. Demographic, pathologic, and clinical information were reviewed to identify patient outcomes.


RESULTS
A total of 44 patients with metastatic non-melanocytic non-hematopoietic tumor to the oral cavity were identified: 24 males and 20 females (39 adults and 5 children) with a mean age of 54.3 years. In all, 24 cases involved the jaw and 20 cases involved the oral soft tissue. Eight patients (18.2%) had oral cavity metastases as the first indication of an occult malignancy. In adult patients, the common primary sites were the lungs (n = 9, 20%), kidney (n = 7, 16%), breast (n = 5, 11%), and colon (n = 4, 9%); and in pediatric patients the adrenal gland (3/5) was the most common site. Of the adult patients, 33 (84.6%) died of disease. From the time of metastasis diagnosis, patients with jaw metastases had a median and mean survival of 12 months and 27.7 months, respectively. In comparison, patients with oral soft tissue metastases had a median survival time of 5 months, and mean of 8 months. One pediatric patient (20%) died of disease 8 months after metastasis diagnosis.


CONCLUSIONS
Metastatic solid tumors to the oral cavity can be the first sign of a malignancy. Pediatric patients with oral cavity metastases have a better prognosis compared to adult patients. In this series, adults with oral soft tissue involvement had shorter survival times compared to patients with jaw involvement.
Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA.
Adepitan A
AA
Owosho
Head and Neck/Endocrine Pathology, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA.
Bin
B
Xu
Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA.
Arvin
A
Kadempour
Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA.
SaeHee K
SK
Yom
Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA.
Joseph
J
Randazzo
Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA.
Ronald A
RA
Ghossein
Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA.
Joseph M
JM
Huryn
Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA. Electronic address: estiloc@mskcc.org.
Cherry L
CL
Estilo
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007573:Jaw Neoplasms / Q000401:mortality / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000556:secondary*; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis
Gingiva; Jaw; Mandible; Metastases; Metastatic tumor; Oral soft tissue