4 Carcinomas That Spread Hematogenously
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*4 Cancers That Spread Hematogenously
*4 Carcinomas That Spread Hematogenouslydoi: 10.4103/0976-237X.96835PMID: 22919227
Papillary carcinoma and its variants usually display a proclivity toward regional lymph node metastasis; however, bloodborne metastases can occur but less commonly than other malignant thyroid tumors.1-4 Hurthle cell carcinoma usually spreads hematogenously, with secondary tumor deposits in lung and bone.1,2,10. Usually are carcinomas rather than sarcomas.4. Prone to spread hematogenously, especially to lung. Lymphatic spread. 6 Thyroid carcinoma metastasizing to. Tumors that directly in vade the colon, or spread hematogenously, tend to involv e the outer layers of the bowel wall with relative sparing of the mucosa (Fig. Why do some carcinomas spread hematogenously So I know the general rule of thumb is that sarcomas spread via the blood and carcinomas via the lymphatics. However, hepatocellular carcinoma, renal cell carcinoma, thyroid follicular carcinoma, and choriocarcinoma spread hematogenously, not lymphatically, thus these are the exceptions.This article has been cited by other articles in PMC.Abstract
Mandibular metastasis due to thyroid carcinoma is not very frequent and the cases described in the literature are few. Due to its bloodstream dissemination, most of them are a consequence of the follicular variant of thyroid carcinomas. We are presenting a case in which the metastatic lesion of mandible was detected before diagnosis of primary malignancy.Keywords: Follicular carcinoma of thyroid, mandible, metastasisIntroduction
Metastatic tumors of oral cavity are very rare, accounting for 1% of neoplasm in the area and their primary origin can be anywhere.[] Most such patients were previously diagnosed with primary neoplasm. The literature states that in about 30% of cases of patients with gnathic bone metastases, the primary tumor is asymptomatic and not diagnosed.[] The most common primary tumors leading to mandibular metastasis were lung in men and breast in women.[] These metastatic lesions (or tumors) usually are carcinomas rather than sarcomas.[]
Mandibular metastasis due to thyroid carcinoma is not very frequent and the cases described in the literature are few. Seneca niagara casino niagara falls ny. Due to its bloodstream dissemination, most of them are a consequence of the follicular variants of thyroid carcinomas.[] We are presenting a case in which the metastatic lesion of mandible was detected before diagnosis of primary malignancy.Case Report
A 40-year-old female patient reported to the oral medicine and radiology department with complaint of growth arising through nonhealing extraction socket since 3 months. Casino las vegas live.
Three months back the patient developed diffuse extraoral swelling over lower left side of the face. After consultation with a local dentist, the patient underwent extraction of lower left first, second, and third molars. However, the swelling persisted even after extraction. Few days after extraction, the patient noticed a small growth arising from extraction socket. It was tender and used to bleed spontaneously. No history of paresthesia/numbness with the concerned region was reported.
The patient also revealed the presence of a small lump in the neck region, which she noticed 3–4 months prior; however, she neglected it as it was asymptomatic.
The patient was averagely built and had been cleaning her teeth with mishri (fine black powder of roasted tobacco leaves) since last 30–35 years.
General examination revealed the presence of lump in the midline of anterior region of neck; it was about 3.5 cm × 3 cm in size, soft to firm in consistency and was nontender. It used to move with swallowing.
Extraoral examination revealed swelling in the lower left side of the face. The swelling was oval shaped and was extending horizontally from mid-portion of left body of mandible to left angle of mandible and vertically from mid-ramus region to inferior border of mandible. It was tender, about 4.5 cm × 4.5 cm in size with bony hard consistency. The patient also presented with bilateral submandibular lymphadenopathy.
Intraoral examination revealed sessile growth [Figure 1] arising from extraction socket of lower left first, second, and third molars. It was about 3.5 cm × 2 cm × 2.5 cm in size with soft consistency and corrugated surface.
Intraoral photograph showing granulomatous growth arising from extraction socket
As the growth was arising from an extraction socket and the patient was a chronic tobacco chewer, a provisional diagnosis of malignant tumor of mandible was considered. The patient was then referred for radiographic examination, computed tomography (CT) scan imaging, complete blood count, and incisional biopsy of the intraoral growth.
OPG [Figure 2] revealed an osteolytic lesion in the lower left first, second, and third molars, which was ill defined, uncorticated. A pathologic fracture of the inferior border of the mandible was also noticed. Bone and soft tissue algorithm of CT scan [Figures [Figures33 and and4]4] examination revealed destructive lesion involving posterior region of body and ramus of the left mandible. On careful examination, soft tissue window revealed an expansile lesion with hyperintense periphery involving thyroid gland.
Orthopantomograph showing ill-defined osteolytic lesion with islands of remaining bone within the interior and pathologic fracture of lower border of mandible left side. (Digitally enhanced image)
Coronal section at bone window level showing osteolytic lesion causing erosion of lower border of left mandible
Axial section at soft tissue window level showing destructive lesion involving posterior region of body and ramus of left mandible
Incisional biopsy of the intraoral growth revealed a metastatic follicular thyroid carcinoma.
The patient was then referred to higher center for further management.Discussion
Follicular thyroid cancer tends to be a malignancy of older persons, with the mean age of patients in most studies being more than 50 years. Although papillary thyroid carcinomas are generally more common than follicular cancers, the latter are more prone to spread hematogenously, especially to lung and bones, with a rate of 5%–20%. Conversely, follicular cancers exhibit a relatively small propensity for lymphatic spread.[]
Metastasis is a consequence of complex biologic cascade that begins with the detachment of tumor cell from primary tumor spreading into the tissues, invading the lymphovascular structures followed by their survival in the circulation.[] The microvasculature of the target organ provides room for the metastatic tumor cells to harbor, from where they can extravagate, proliferate, and invade within this target tissue. Angiogenesis is mandatory for the tumor cell load beyond 2–3 mm for adequate supply of oxygen and nutrients.[] Recent studies on the mechanism by which cancer metastasizes to bone have shown that cancer cells alter the physiologic balance between bone resorption and bone formation. Breast cancer metastases are frequently osteolytic and this has been attributed to overexpression of osteoclasts, inducing factors such as parathyroid hormone–related protein, interleukin (IL)-8, and IL-11.[] Predominantly osteoblastic metastasis is mediated by osteoblast-mediating factors, such as bone morphogenetic proteins, Wnt family ligands, endothelin 1, and platelet derived growth factors (PGDF). Furthermore, the release of matrix embedded growth factors, such as insulin-like growth factors and transforming growth factor-beta upon osteolysis promotes the induction of osteoclast-promoting factors.[]
Reports from different parts of the world show a variable incidence of metastasis to jaw bone from different primary sites, ranging from 1–4 cases per year.[,] Most of the metastatic tumors occur in 5th, 6th, and 7th decades[,]; however, in an Indian study the metastatic tumors were found to occur at an early age between the 3rd and 7th decade. In the younger age group (first to second decade) the metastasis was found to occur from adrenal neuroblastoma, medulloblastoma, and osteogenic sarcoma.[] The clinical presentations of the metastatic lesions include pain, swelling, loosening of tooth, paresthesia, and pathologic fracture.[,] Less frequently the lesion can present as pain in the temporomandibular joint region or as an osteomyelitis in the jaw or as trigeminal neuralgia.[] Studies have shown that chronic trauma to the oral tissue favors metastatic spread to the oral cavity.[14] In another study it was found that in 55 cases tooth extraction preceded the discovery of metastasis.[] In the majority of the cases, a latency period of 2 months between the extraction and the development of the metastasis was reported. In our case also we observed a similar finding. Thus the role of trauma to the oral mucosa in the causation of oral metastasis needs further investigation.
Emre and Ehab studied various cases and observed that the most frequent location for metastasis among jaw bones is mandible. In the mandible, ramus and angle are more commonly involved. They concluded that the propensity of posterior mandible for metastasis is due to its better vascularity.[] A few investigators believe that metastasis to jaw bone through hematogenous route requires the presence of hematopoietically active bone marrow well connected with the sinusoidal vascular spaces at the site of deposition of malignant cells.[,]
The posterior mandible and the focal osteoporotic bone marrow defects in the edentulous mandible have been shown to be the hematopoietically active sites that may attract the metastatic tumor cells.[,] Still some other investigators believe that the high bone turnover in this region may be the cause.[]
Although the incidence of metastatic tumors in oral cavity is considered low, a significant number of such lesions have a high tendency to go undetected, this is because of the following:
*
Micrometastasis is rarely detected by radiographic survey.[]
*
Cases with poor prognosis and terminal stage of the disease lose or are dead before presenting to a clinician.[]
*
Earlier jaw bones were not included in the radiographic survey for metastatic workup.[]
The exact incidence of metastatic diseases that affect the mandible is still unknown. Hence all medical and dental clinicians must include malignant disease, primary or metastatic, alongside the more common benign pathologies when considering the differential diagnosis of oral complaints. This is particularly important in the primary care setting, especially when dealing with elderly patients, or those with a history of malignancy.Footnotes
Source of Support: Nil.
Conflict of Interest: None declared.References1. Van der Waal RI, Buter J, van der Waal I. Oral metastasis: Report of 24 cases. Br J Oral Maxillofac Surg. 2003;41:3–6. [PubMed] [Google Scholar]2. Bodner L, Geffen DB. Metastatic tumor of the jaw-diagnosis and management. (81).Refuat Hapeh Vehashinayim. 2003;20:59–61. [PubMed] [Google Scholar]3. Hirshberg A, Buchner A. Metastatic tumors to oral region an overview. Eur J Cancer B Oral Oncol. 1995;31B:355–60. [PubMed] [Google Scholar]4. Keller EE, Gunderson LL. Bone disease metastatic to the jaws. J Am Dent Assoc. 1987;115:697–701. [PubMed] [Google Scholar]5. Ostrosky A, Mareso EA, Klurfan FJ, Gonzalez JM. Mandibular metastasis of follicular thyroid carcinoma. Case report. Med Oral. 2003;8:224–7. [PubMed] [Google Scholar]6. Grebe SK, Hay ID. Follicular thyroid cancer. Endocrinol Metab Clin North Am. 1995;24:761–801. [PubMed] [Google Scholar]7. Hirshberg A, Leibovih P, Buchner A. Metastatic tumors to the jaw bone; analysis of 390 cases. Oral Pathol Med. 1994;23:337–41. [PubMed] [Google Scholar]8. Hanahan D, Weinberg RA. The hallmark of cancers. Cell. 2000;100:57–70. [PubMed] [Google Scholar]9. Mundy GR. Metastasis to bone; causes, consequences and therapeutic opportunities. Nat Rev Cancer. 2002;2:584–93. [PubMed] [Google Scholar]4 Cancers That Spread Hematogenously10. Cumming J, Hacking N, Fairhurst J, Ackery D, Jenkins JD. Distribution of bony metastasis in prostatic carcinoma. Br J Urol. 1990;66:411–4. [PubMed] [Google Scholar]11. Hirshberg A, Shniaderman-Shapiro A, Kaplan I, Rannan B. Metastatic tumors to the oral cavity- pathogenesis & analysis of 673 cases. Oral Oncol. 2008;44:743–52. [PubMed] [Google Scholar]12. Muttagi SS, Chaturvedi P, D’Cruz A, Kane S, Chaukar D, Pai P, Singh B, Pawar P. Metastatic tumors to the jaw bones: Retrospective analysis from an Indian tertiary referral center. Indian J Cancer. 2011;48:234–9. [PubMed] [Google Scholar]13. Glaser C, Lang S, Pruckmayer M, Millesi W, Rasse M, Marosi C, et al. Clinical manifestations and diagnostic approach to metastatic cancer of the mandible. Int J Oral Maxillofac Surg. 1997;26:365–8. [PubMed] [Google Scholar]14. Monkman GR, Orwoll G, Ivinis JC. Trauma and oncogenesis. Mayo Clin Proc. 1974;49:257–63.[Google Scholar]4 Carcinomas That Spread Hematogenously15. Hirshberg A, Leibovih P, Horowitz I, Buchner A. Metastatic tumors to the post extraction site. J Oral Maxillofac Surg. 1993;51:1334–7. [PubMed] [Google Scholar]16. Vural E, Hanna E. Metastatic follicular thyroid carcinoma to the mandible: A case report and review of the literature. Am J Otolaryn. 1998;19:198–202. [PubMed] [Google Scholar]17. Kricum ME. Red yellow marrow conversion, its effect on the location of some solitary bone lesions. Skeletal Radiol. 1985;14:10–3. [PubMed] [Google Scholar]18. Morgan JW, Adcock KA, Donhouse RE. Distribution of skeletal metastasis in prostatic and lung cancer: Mechanism of skeletal metastasis. Urology. 1990;36:31–4. [PubMed] [Google Scholar]19. Hashimoto N, Kurihara K, Yamasaki H, Ohba S, Sakai H, Yoshida S. Pathological characteristic of metastatic carcinoma in human mandible. J Oral Pathol. 1987;16:362–7. [PubMed] [Google Scholar]20. Standish SM, Shafer WG. Focal osteoporotic bone marrow defects of the jaws. J Oral Surg. 1962;20:123–8. [PubMed] [Google Scholar]21. D’Silva NJ, Summerlin D-J, Cordell KG, Abdelsayedc RA, Tomich CE, Hanks CT, et al. Metastatic tumors in the jaws. A retrospective study of 114 cases. J Am Dent Assoc. 2006;137:1667–72. [PubMed] [Google Scholar]22. Lindermann F, Schilmok G, Dirscheld P, Witte J, Reithmuller G. Prognostic significance of micro-metastasis tumor cells in bone marrow of colorectal cancer patients. Lancet. 1992;340:685–9. [PubMed] [Google Scholar]Articles from Contemporary Clinical Dentistry are provided here courtesy of Wolters Kluwer -- Medknow Publications
Register here: http://gg.gg/wa9hx
https://diarynote-jp.indered.space
*4 Cancers That Spread Hematogenously
*4 Carcinomas That Spread Hematogenouslydoi: 10.4103/0976-237X.96835PMID: 22919227
Papillary carcinoma and its variants usually display a proclivity toward regional lymph node metastasis; however, bloodborne metastases can occur but less commonly than other malignant thyroid tumors.1-4 Hurthle cell carcinoma usually spreads hematogenously, with secondary tumor deposits in lung and bone.1,2,10. Usually are carcinomas rather than sarcomas.4. Prone to spread hematogenously, especially to lung. Lymphatic spread. 6 Thyroid carcinoma metastasizing to. Tumors that directly in vade the colon, or spread hematogenously, tend to involv e the outer layers of the bowel wall with relative sparing of the mucosa (Fig. Why do some carcinomas spread hematogenously So I know the general rule of thumb is that sarcomas spread via the blood and carcinomas via the lymphatics. However, hepatocellular carcinoma, renal cell carcinoma, thyroid follicular carcinoma, and choriocarcinoma spread hematogenously, not lymphatically, thus these are the exceptions.This article has been cited by other articles in PMC.Abstract
Mandibular metastasis due to thyroid carcinoma is not very frequent and the cases described in the literature are few. Due to its bloodstream dissemination, most of them are a consequence of the follicular variant of thyroid carcinomas. We are presenting a case in which the metastatic lesion of mandible was detected before diagnosis of primary malignancy.Keywords: Follicular carcinoma of thyroid, mandible, metastasisIntroduction
Metastatic tumors of oral cavity are very rare, accounting for 1% of neoplasm in the area and their primary origin can be anywhere.[] Most such patients were previously diagnosed with primary neoplasm. The literature states that in about 30% of cases of patients with gnathic bone metastases, the primary tumor is asymptomatic and not diagnosed.[] The most common primary tumors leading to mandibular metastasis were lung in men and breast in women.[] These metastatic lesions (or tumors) usually are carcinomas rather than sarcomas.[]
Mandibular metastasis due to thyroid carcinoma is not very frequent and the cases described in the literature are few. Seneca niagara casino niagara falls ny. Due to its bloodstream dissemination, most of them are a consequence of the follicular variants of thyroid carcinomas.[] We are presenting a case in which the metastatic lesion of mandible was detected before diagnosis of primary malignancy.Case Report
A 40-year-old female patient reported to the oral medicine and radiology department with complaint of growth arising through nonhealing extraction socket since 3 months. Casino las vegas live.
Three months back the patient developed diffuse extraoral swelling over lower left side of the face. After consultation with a local dentist, the patient underwent extraction of lower left first, second, and third molars. However, the swelling persisted even after extraction. Few days after extraction, the patient noticed a small growth arising from extraction socket. It was tender and used to bleed spontaneously. No history of paresthesia/numbness with the concerned region was reported.
The patient also revealed the presence of a small lump in the neck region, which she noticed 3–4 months prior; however, she neglected it as it was asymptomatic.
The patient was averagely built and had been cleaning her teeth with mishri (fine black powder of roasted tobacco leaves) since last 30–35 years.
General examination revealed the presence of lump in the midline of anterior region of neck; it was about 3.5 cm × 3 cm in size, soft to firm in consistency and was nontender. It used to move with swallowing.
Extraoral examination revealed swelling in the lower left side of the face. The swelling was oval shaped and was extending horizontally from mid-portion of left body of mandible to left angle of mandible and vertically from mid-ramus region to inferior border of mandible. It was tender, about 4.5 cm × 4.5 cm in size with bony hard consistency. The patient also presented with bilateral submandibular lymphadenopathy.
Intraoral examination revealed sessile growth [Figure 1] arising from extraction socket of lower left first, second, and third molars. It was about 3.5 cm × 2 cm × 2.5 cm in size with soft consistency and corrugated surface.
Intraoral photograph showing granulomatous growth arising from extraction socket
As the growth was arising from an extraction socket and the patient was a chronic tobacco chewer, a provisional diagnosis of malignant tumor of mandible was considered. The patient was then referred for radiographic examination, computed tomography (CT) scan imaging, complete blood count, and incisional biopsy of the intraoral growth.
OPG [Figure 2] revealed an osteolytic lesion in the lower left first, second, and third molars, which was ill defined, uncorticated. A pathologic fracture of the inferior border of the mandible was also noticed. Bone and soft tissue algorithm of CT scan [Figures [Figures33 and and4]4] examination revealed destructive lesion involving posterior region of body and ramus of the left mandible. On careful examination, soft tissue window revealed an expansile lesion with hyperintense periphery involving thyroid gland.
Orthopantomograph showing ill-defined osteolytic lesion with islands of remaining bone within the interior and pathologic fracture of lower border of mandible left side. (Digitally enhanced image)
Coronal section at bone window level showing osteolytic lesion causing erosion of lower border of left mandible
Axial section at soft tissue window level showing destructive lesion involving posterior region of body and ramus of left mandible
Incisional biopsy of the intraoral growth revealed a metastatic follicular thyroid carcinoma.
The patient was then referred to higher center for further management.Discussion
Follicular thyroid cancer tends to be a malignancy of older persons, with the mean age of patients in most studies being more than 50 years. Although papillary thyroid carcinomas are generally more common than follicular cancers, the latter are more prone to spread hematogenously, especially to lung and bones, with a rate of 5%–20%. Conversely, follicular cancers exhibit a relatively small propensity for lymphatic spread.[]
Metastasis is a consequence of complex biologic cascade that begins with the detachment of tumor cell from primary tumor spreading into the tissues, invading the lymphovascular structures followed by their survival in the circulation.[] The microvasculature of the target organ provides room for the metastatic tumor cells to harbor, from where they can extravagate, proliferate, and invade within this target tissue. Angiogenesis is mandatory for the tumor cell load beyond 2–3 mm for adequate supply of oxygen and nutrients.[] Recent studies on the mechanism by which cancer metastasizes to bone have shown that cancer cells alter the physiologic balance between bone resorption and bone formation. Breast cancer metastases are frequently osteolytic and this has been attributed to overexpression of osteoclasts, inducing factors such as parathyroid hormone–related protein, interleukin (IL)-8, and IL-11.[] Predominantly osteoblastic metastasis is mediated by osteoblast-mediating factors, such as bone morphogenetic proteins, Wnt family ligands, endothelin 1, and platelet derived growth factors (PGDF). Furthermore, the release of matrix embedded growth factors, such as insulin-like growth factors and transforming growth factor-beta upon osteolysis promotes the induction of osteoclast-promoting factors.[]
Reports from different parts of the world show a variable incidence of metastasis to jaw bone from different primary sites, ranging from 1–4 cases per year.[,] Most of the metastatic tumors occur in 5th, 6th, and 7th decades[,]; however, in an Indian study the metastatic tumors were found to occur at an early age between the 3rd and 7th decade. In the younger age group (first to second decade) the metastasis was found to occur from adrenal neuroblastoma, medulloblastoma, and osteogenic sarcoma.[] The clinical presentations of the metastatic lesions include pain, swelling, loosening of tooth, paresthesia, and pathologic fracture.[,] Less frequently the lesion can present as pain in the temporomandibular joint region or as an osteomyelitis in the jaw or as trigeminal neuralgia.[] Studies have shown that chronic trauma to the oral tissue favors metastatic spread to the oral cavity.[14] In another study it was found that in 55 cases tooth extraction preceded the discovery of metastasis.[] In the majority of the cases, a latency period of 2 months between the extraction and the development of the metastasis was reported. In our case also we observed a similar finding. Thus the role of trauma to the oral mucosa in the causation of oral metastasis needs further investigation.
Emre and Ehab studied various cases and observed that the most frequent location for metastasis among jaw bones is mandible. In the mandible, ramus and angle are more commonly involved. They concluded that the propensity of posterior mandible for metastasis is due to its better vascularity.[] A few investigators believe that metastasis to jaw bone through hematogenous route requires the presence of hematopoietically active bone marrow well connected with the sinusoidal vascular spaces at the site of deposition of malignant cells.[,]
The posterior mandible and the focal osteoporotic bone marrow defects in the edentulous mandible have been shown to be the hematopoietically active sites that may attract the metastatic tumor cells.[,] Still some other investigators believe that the high bone turnover in this region may be the cause.[]
Although the incidence of metastatic tumors in oral cavity is considered low, a significant number of such lesions have a high tendency to go undetected, this is because of the following:
*
Micrometastasis is rarely detected by radiographic survey.[]
*
Cases with poor prognosis and terminal stage of the disease lose or are dead before presenting to a clinician.[]
*
Earlier jaw bones were not included in the radiographic survey for metastatic workup.[]
The exact incidence of metastatic diseases that affect the mandible is still unknown. Hence all medical and dental clinicians must include malignant disease, primary or metastatic, alongside the more common benign pathologies when considering the differential diagnosis of oral complaints. This is particularly important in the primary care setting, especially when dealing with elderly patients, or those with a history of malignancy.Footnotes
Source of Support: Nil.
Conflict of Interest: None declared.References1. Van der Waal RI, Buter J, van der Waal I. Oral metastasis: Report of 24 cases. Br J Oral Maxillofac Surg. 2003;41:3–6. [PubMed] [Google Scholar]2. Bodner L, Geffen DB. Metastatic tumor of the jaw-diagnosis and management. (81).Refuat Hapeh Vehashinayim. 2003;20:59–61. [PubMed] [Google Scholar]3. Hirshberg A, Buchner A. Metastatic tumors to oral region an overview. Eur J Cancer B Oral Oncol. 1995;31B:355–60. [PubMed] [Google Scholar]4. Keller EE, Gunderson LL. Bone disease metastatic to the jaws. J Am Dent Assoc. 1987;115:697–701. [PubMed] [Google Scholar]5. Ostrosky A, Mareso EA, Klurfan FJ, Gonzalez JM. Mandibular metastasis of follicular thyroid carcinoma. Case report. Med Oral. 2003;8:224–7. [PubMed] [Google Scholar]6. Grebe SK, Hay ID. Follicular thyroid cancer. Endocrinol Metab Clin North Am. 1995;24:761–801. [PubMed] [Google Scholar]7. Hirshberg A, Leibovih P, Buchner A. Metastatic tumors to the jaw bone; analysis of 390 cases. Oral Pathol Med. 1994;23:337–41. [PubMed] [Google Scholar]8. Hanahan D, Weinberg RA. The hallmark of cancers. Cell. 2000;100:57–70. [PubMed] [Google Scholar]9. Mundy GR. Metastasis to bone; causes, consequences and therapeutic opportunities. Nat Rev Cancer. 2002;2:584–93. [PubMed] [Google Scholar]4 Cancers That Spread Hematogenously10. Cumming J, Hacking N, Fairhurst J, Ackery D, Jenkins JD. Distribution of bony metastasis in prostatic carcinoma. Br J Urol. 1990;66:411–4. [PubMed] [Google Scholar]11. Hirshberg A, Shniaderman-Shapiro A, Kaplan I, Rannan B. Metastatic tumors to the oral cavity- pathogenesis & analysis of 673 cases. Oral Oncol. 2008;44:743–52. [PubMed] [Google Scholar]12. Muttagi SS, Chaturvedi P, D’Cruz A, Kane S, Chaukar D, Pai P, Singh B, Pawar P. Metastatic tumors to the jaw bones: Retrospective analysis from an Indian tertiary referral center. Indian J Cancer. 2011;48:234–9. [PubMed] [Google Scholar]13. Glaser C, Lang S, Pruckmayer M, Millesi W, Rasse M, Marosi C, et al. Clinical manifestations and diagnostic approach to metastatic cancer of the mandible. Int J Oral Maxillofac Surg. 1997;26:365–8. [PubMed] [Google Scholar]14. Monkman GR, Orwoll G, Ivinis JC. Trauma and oncogenesis. Mayo Clin Proc. 1974;49:257–63.[Google Scholar]4 Carcinomas That Spread Hematogenously15. Hirshberg A, Leibovih P, Horowitz I, Buchner A. Metastatic tumors to the post extraction site. J Oral Maxillofac Surg. 1993;51:1334–7. [PubMed] [Google Scholar]16. Vural E, Hanna E. Metastatic follicular thyroid carcinoma to the mandible: A case report and review of the literature. Am J Otolaryn. 1998;19:198–202. [PubMed] [Google Scholar]17. Kricum ME. Red yellow marrow conversion, its effect on the location of some solitary bone lesions. Skeletal Radiol. 1985;14:10–3. [PubMed] [Google Scholar]18. Morgan JW, Adcock KA, Donhouse RE. Distribution of skeletal metastasis in prostatic and lung cancer: Mechanism of skeletal metastasis. Urology. 1990;36:31–4. [PubMed] [Google Scholar]19. Hashimoto N, Kurihara K, Yamasaki H, Ohba S, Sakai H, Yoshida S. Pathological characteristic of metastatic carcinoma in human mandible. J Oral Pathol. 1987;16:362–7. [PubMed] [Google Scholar]20. Standish SM, Shafer WG. Focal osteoporotic bone marrow defects of the jaws. J Oral Surg. 1962;20:123–8. [PubMed] [Google Scholar]21. D’Silva NJ, Summerlin D-J, Cordell KG, Abdelsayedc RA, Tomich CE, Hanks CT, et al. Metastatic tumors in the jaws. A retrospective study of 114 cases. J Am Dent Assoc. 2006;137:1667–72. [PubMed] [Google Scholar]22. Lindermann F, Schilmok G, Dirscheld P, Witte J, Reithmuller G. Prognostic significance of micro-metastasis tumor cells in bone marrow of colorectal cancer patients. Lancet. 1992;340:685–9. [PubMed] [Google Scholar]Articles from Contemporary Clinical Dentistry are provided here courtesy of Wolters Kluwer -- Medknow Publications
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