Metastatic carcinoma of the jaws: a review of literature.

Introduction: Although metastatic jaw lesions are rare, clinicians must be aware of occurrence and should include them in their catalogue of differential diagnoses with a view to requesting for useful investigations that will aid timely consult and available palliative interventions. The aim of this study is to review and analyze the epidemiological behaviour of jaw metastases that have been reported in literature.

Method: The review was conducted at the Oral and Maxillofacial Department of the University of Port Harcourt Teaching Hospital. Information was obtained from articles written by various authors in Nigeria and other parts of the world and from the internet services provided by the Information and computer training centre of the University of Port Harcourt. A total of 31 articles were reviewed. The distribution, clinical manifestation at the secondary sites, investigations and treatment of the metastatic jaw diseases from the various primary sites were reviewed and documented.

Result: A total of 890 cases were reviewed, males were 402 and females were 488. The age range was 13 to 75 years with a mean age 43 years. The mandible was involved more than the maxilla. In 30% of cases, there were no symptoms at the secondary sites, lesion were detected by radiographs and scintiscanning. Other patients presented with jaw/facial swelling and pain. The breast was the commonest primary site in females and the lung in males. Histopathology was used to confirm the metastatic lesions and 61% of them were found to be adenocarcinoma. Less than half of the cases were operable, and surgery of primary and secondary sites was combined with radiotherapy and chemotherapy in these cases. Prognosis was poor with varying survival rates.

Conclusion: Despite the fact that metastases to the jaws are rare than other bones of the body, these may be the first indication of a malignancy elsewhere in the body and this necessitates that suspected jaw swelling should be thoroughly evaluated to expedite treatment.