Oral and maxillofacial metastasis of breast cancer: a case report and literature review

Abstract

Objective: Oral metastases are relatively rare. In women, the most common oral metastases originate from breast cancer, most diagnosed malignancy and the second leading cause of death. The aim of this study was to review the literature regarding oral metastases from breast cancer with the help of a case report, with a focus on clinical and radiographical features and differential diagnosis. Materials and Methods: The English-language literature between 1980 and 2020 was searched for cases of metastatic lesions to the oral cavity, including bone and soft tissue. Clinical and histopathological data were collected from selected articles. Results: 81 studies were included in the analysis, with a total of 191 affected patients. 97% were women (mean age 54.6) and the remaining 3% were men (mean age 65.2). Adenocarcinoma was the most frequent histotype (33%) followed by ductal carcinoma (17%). In 102 patients (51.5 %), oral metastases were intra-osseous and the remaining 96 patients (48.5%) showed metastases to soft tissues. The primary breast tumor was already known before the onset of the oral metastatic lesion (76.4%). The average time between primary tumor diagnosis and appearance of the oral metastases was 3.8 years. 73% of the patients died, the mean survival time from oral metastasis diagnosis was 21.6 months. Conclusions: Oral metastases can present both clinically and radiographically very similar to other benign lesions frequently encountered in clinical dental practice. In most cases, the patient has developed the primary neoplasm before oral metastasis, therefore, a complete anamnesis is decisive. Once the diagnostic hypothesis and the differential diagnosis have been established, the histopathological examination is fundamental; therefore, it must always be performed.

Keywords

• breast cancer
• case report
• gingiva
• jaw bone
• literature review
• metastasis
• oral cavity