J Korean Assoc Oral Maxillofac Surg.  2019 Oct;45(5):294-298. 10.5125/jkaoms.2019.45.5.294.

Distant metastasis of follicular thyroid carcinoma to the mandible: a rare case report

Affiliations
  • 1Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Cheonan, Korea. kimchoms@dankook.ac.kr

Abstract

Treatment of metastatic carcinoma of the oral cavity can be a challenge due to its rarity. The current case report details metastatic carcinoma of the mandible originating from follicular thyroid carcinoma, which is the second most prevalent tumor of the thyroid. As the mandibular lesion developed, the primary thyroid lesion of thyroid. Here, we report a case of metastatic carcinoma of the mandible in a 67-year-old female that was treated with partial mandibulectomy and fibular free flap.

Keyword

Neoplasm metastasis; Mandible; Thyroid neoplasms; Adenocarcinoma; Follicular

MeSH Terms

Adenocarcinoma
Adenocarcinoma, Follicular*
Aged
Female
Free Tissue Flaps
Humans
Mandible*
Mouth
Neoplasm Metastasis*
Thyroid Gland
Thyroid Neoplasms

Figure

  • Fig. 1 A. The picture shows gingival swelling on right mandible body area. In palpation, there is hardness on swelling region. B. Patient is suffered with mandibular swelling on right body area.

  • Fig. 2 A. Panoramic radiograph shows a lobulated or scalloped margin mass involving the right mandible. Absorption of the roots are not apparent. B. Computed tomography (CT) without enhancement shows bony destruction in same area. C. CT with enhancement reveals enhancing mass involving inner and outer cortex of the right mandible body. It is different with any other odontogenic cysts. D, E. Magnetic resonance imaging presents enhancing mass involving the right mandible body same as computed tomography.

  • Fig. 3 A. Bone scan shows swelling with hollow mass in right mandible. B, C. Positron emission tomography-computed tomography reveals hypermetabolic lesion in right mandible body and left thyroid nodule.

  • Fig. 4 A. Microscopic characteristics. A. Cluster of colloid-filled follicles are identified with matured bone tissue of mandible (H&E staining, ×100). B. Neoplastic follicles are surrounded with tumor cells (H&E staining, ×200).

  • Fig. 5 Current state of the patient. A. Postoperative panoramic view was taken in March 2018. Plate and screws of anterior mandible was removed. B. Osteocutaneous fibular free flap is stabilized and keratinized. Temporary denture is used for adaptation.


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