41 / 2021-10-13 22:38:13

Analysis of clinical and CT features of metastatic adenocarcinoma of the jaw

Metastasis, Adenocarcinoma, Jawbone, Characteristic feature, Computed tomography

Objectives: To explore the clinical and computed tomography (CT) features of metastatic adenocarcinoma of the jaw (MAJ) with oral and maxillofacial lesions as the first symptom.

Methods: Fourteen cases of MAJ from 2006 to 2020 were collected, and clinical and CT features were analysed retrospectively.

Results: The primary sites were the lung (n = 6), liver (n = 4), kidney (n = 2), prostate (n = 1) and gastric cardia (n = 1). A radiological classification scheme of five types was tentatively proposed to discuss the complex CT features. Five cases were classified as osteolytic type with a permeative margin (100%, P < 0.05), and three were classified as mixed type, mostly with a moth-eaten margin (80%, P < 0.05). Cystic (n = 3) and alveolar bone resorption (n = 1) types had geographic margins, and osteoblastic-type (n = 1) had sclerotic margins. Moreover, nine cases showed periosteal reaction and five showed localised soft tissue mass, while the occurrence of jaw expansion was relatively rare.

Conclusions: MAJ is predominant in middle-aged and elderly men, and the most common site is the posterior mandible. This is the first time that a cystic and alveolar bone resorption type are proposed tentatively based on the jawbone structure. MAJ is characterised by numb chin syndrome (SCN), as well as a rapidly progressive osteolytic bone destruction with periosteal reaction and localised soft tissue mass, usually without jaw expansion on CT, which provides a basis for the clinical diagnosis of MAJ in the future.