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

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.

Differential Diagnosis of Oral Metastases

“…In the hard tissue, the mandible was the most affected site (Aniceto et al, 1990;Sánchez-Jiménez et al, 2005;Hirshberg et al, 2008;Barnes, 2009;Kumar & Manjunatha, 2013;Kirschnick et al, 2020;Labrador et al, 2021) probably because of the higher content of hematopoietic marrow (Van der Kwast & Van der Waal, 1974;Zachariades, 1989;Aniceto et al, 1990). Solid organ tumors target certain organs as secondary foci, such as cancers originating from the breast, prostate gland and thyroid have a high tropism for bone tissues, and as a result they have a larger propensity to affect the jaws (Jeon et al, 2019). The presence of pain and swelling could be explained by the endothelin axis, a pathway composed of the endothelin A and B receptors.…”

Oral metastasis as the first indication of undiscovered malignancy at a distant site: A systematic review of 413 cases

“…In the hard tissues, the mandible was predominantly the most affected site (91.0%), maybe because it contains more hematopoietic marrow 29,30 . Breasts, prostate glands, and thyroid have high tropism for bone tissues and, thus, are most likely to affect the jaws 31 . For the breasts and prostate glands, there seemed to be also an association with hormonal factors, which facilitated the interaction of malignant cells with osteoblasts and osteoclasts, both by mutual stimulation and imitation 32 .…”

“…29,30 Breasts, prostate glands, and thyroid have high tropism for bone tissues and, thus, are most likely to affect the jaws. 31 For the breasts and prostate glands, there seemed to be also an association with hormonal factors, which facilitated the interaction of malignant cells with osteoblasts and osteoclasts, both by mutual stimulation and imitation. 32 The growth factors present in the bone tissue may also be activated and contribute to the remodeling process induced by malignant cells.…”