No abstract

Metastatic tumors of the oral region are relatively rare and comprise approximately 1 % of malignant oral neoplasms. Their prognosis is generally very poor because of systemic metastases. We clinically studied 17 cases of metastatic tumors of the oral region. Fourteen of the 17 patients were male and 3 were female. The mean age was 56.6 years. Metastases to the mandible were twice as frequent as those to the maxilla. The most common location of the metastatic lesions was the molar region of the jaws. The most common symptom of metastatic lesions was swelling. Paresthesia of the mental nerve was present in 4 patients. The most common site of the primary tumor was the lung, followed by the colon. Histologically, adenocarcinomas had the far highest rate of metastasis to the oral region. If both the primary tumor and generalized metastasis are controlled, the oral tumor must be aggressively treated. However, when the primary tumor was controlled but generalized metastasis was uncontrolled, patients died within 6 months despite oral treatment. Patients with uncontrolled primary tumors died within 7 months despite oral control, except for one patient who survived 13 months.

Spindle cell carcinoma (SpCC) is a biphasic tumor consisting of a squamous cell carcinoma component and a sarcomatoid component of spindle cells. Without immunohistochemical or ultrastructural study, it is difficult to differentiate the sarcomatoid component of SpCC from sarcoma.We describe a case of spindle cell carcinoma arising as a polypoid mass in the tongue of a 74-year-old woman. The mass was successfully differentially diagnosed on immunohistochemical analysis. Pathological analysis of the tumor revealed three components of squamous cells, histiocyte-like cells, and spindle cells. Immunohistochemical characterization of tumor cells was done with antibodies to keratin, vimentin, smooth muscle actin, desmin, and 5-100 protein to differentiate SpCC from melanoma and leiomyosarcoma. The histiocyte-like cells and spindle cells were positive for keratin and vimentin, and negative for smooth muscle actin, desmin, and 5-100 protein. Given these findings, we diagnosed SpCC. In the 7 months following surgery, there has been no local recurrence or metastasis.