Journeying (metastatic) cancer cells seeding in the Oral Cavity

ABSTRACT

Background and Settings: Metastasis is a complex organic passage of cancer cells that detach from the primary tumor and spreads to the distant tissues and/or organs, by traversing through the lymphovascular channels; at all times remaining, viable. Metastatic tumors to the oro-facial regions are rare; but when present may mimic many of the commonly occurring inflammatory and neoplastic lesions arising primarily in the oral cavity; therefore, the need for their deliberation in the differential diagnosis of oral lesions.

Aims and Objectives: The meta-analysis of the metastasis to the oral cavity is carried out to consolidate the data regarding the prevalent metastasis.

Data Sources: Original articles for inclusion was earmarked through keyword searches in PubMed indexed, Google Scholar, Medline Search, DOAJ and other search engines.

Study Eligibility Criteria: Case reports from all over the world that reported metastatic spread of cancer to the oral cavity. In total, 120 original case reports were included.

Synthesis Methods: Analysis of mean impacts and meta-regressions to examine factors that influence outcomes.

Results: Among the reported cases: breast cancer (23/120) showed maximum oral metastasis, followed by the lung (18/120). The least number of oral metastasis occurred in the case of neuroendocrine carcinoma (2/120) and the angiosarcoma of heart (1/120). All metastatic tumors presented as an asymptomatic swelling of the jaw, especially the mandible, arising within 2 months of diagnosis of the primary tumor. Many cases also reported the lip, chin numbness syndrome; a diagnostic sign for oral metastasis.

Limitations: Incomplete history of the reported cases was a major drawback of this study.

Conclusion: The meta-analysis provides robust evidence that would educate the dental physicians, with respect to the varied oral manifestations of the metastatic lesions to the oral cavity.