Lung Adenocarcinoma Metastasis to the Jawbone-A Case Report

由肺腺癌引起的下顎骨轉移－病例報告

Chin-Chih Shih(史謹誌)；Che-Hsun Wu(吳哲勛)；Chun-Pin Chiang(江俊斌)；Kwang-Yu Hu(胡廣煜)；Pin-Yi Lin(林秉毅)；Yu-Hsueh Wu(吳昱學)；Ju-Hsuan Yang(楊濡瑄)

Lung cancer ； Adenocarcinoma ； Jawbone metastasis ； Oral cancer ； 肺癌 ； 腺癌 ； 下顎骨轉移 ； 口腔癌

臺灣口腔顎面外科學會雜誌

35卷3期（2024 / 09 / 01）

242 - 250

英文;繁體中文

We presented a case of metastatic lung adenocarcinoma to the jawbone. The clinical examination revealed mild mandible bone expansion with intact oral mucosa. The patient had a history of spinal cord neurilemoma and lipoma. Following a series of evaluations including CT imaging, aspiration biopsy, and ENT examination, the possibilities of submandibular fibroma, neurilemoma, lipoma, primary malignant neoplasm, and metastasis were considered. Surgery involving tumor excision with partial bone removal and selective lymph node dissection was performed for diagnostic purposes. Post-operatively, metastatic lung adenocarcinoma to the jawbone was diagnosed. Subsequently, lung cancer with brain metastasis was also identified. The patient began chemotherapy immediately following these diagnoses but unfortunately expired four months later. The case of metastatic lung adenocarcinoma in the oral and maxillofacial region is challenging to diagnose without additional symptoms at the onset. We documented this case to serve as a reference for clinical diagnosis.

此病例報告為轉移性肺腺癌遠端轉移至下頜骨的病人。臨床檢查顯示下顎骨輕度膨脹，口腔粘膜完整。經影像學、細菌培養及耳鼻喉檢查，合併先前之脊髓神經鞘瘤和脂肪瘤病史，初步診斷有：右下顎神經鞘瘤、脂肪、纖維瘤、惡性腫瘤或轉移，並安排診斷為目的之手術切除及淋巴結摘除。術後經組織病理及免疫螢光學檢查，診斷為下顎骨轉移性肺腺癌併頸淋巴結轉移。患者經診斷後，進一步檢查發現腦部轉移以及肺部腫瘤，並立即接受化療，但四個月後不幸逝世。肺腺癌轉移至下頜骨的病例罕見且在初期難以診斷，呈現此案例檢查和診斷過程以為參考，以提高臨床醫師的警覺性。