Oral Oncology Extra 2006;42:224-6

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口腔病理科 On-Line KMU Student Bulletin

原文題目(出處)： Condylar metastasis involving TMJ and TMJ dislocation presenting as the initial manifestation of squamous lung cancer

Oral Oncology Extra 2006;42:224-6

原文作者姓名： Murat Sari, Gediz Murat Serin, Selcuk Inanli, Handan Kaya 通訊作者學校： Marmara University School of Medicine, Istanbul, Turkey 報告者姓名(組別)：黃南傑(int. D)

報告日期： 95.11.19

內文：

1. Introduction

z Lung cancer is the most frequently diagnosed cancer and the most common cause of cancer related death in both men and women in the world.

z Lung cancer commonly metastasizes to the regional lymph nodes, liver, adrenal glands, bones and kidney.

2. Case report

z General data:

¾ 65-year-old man

¾ C.C: pain and dislocation of the right TMJ.

¾ PE: no respiratory symptoms like cough, dispnea or hemopthsis.

¾ Habits: occasional social drinker and no history of smoking.

z Clinical finding:

¾ Dislocation and sensitiveness in the area of the right TMJ.

z Image finding:

¾ A bulky lesion in the right infratemporal fossa with extensive destruction of the condyle and TMJ extending to the parotid gland (CT & MRI)

¾ A parenchymal lesion, in the right hilar region which was obliterating the main bronchus (Chest CT)

¾ A white colored endobronchial growth with necrotic surface obliterating the right main bronchus (Bronchoscopic examination)

z Histopathological diagnosis:

¾ Squamous cell carcinoma of the lung.

z Treatment:

¾ Primary lung tumor was operable and right pulmonectomy

¾ Mandibular condyle and the mass was excised

¾ Improve Oral function, nutritional status, and quality of life

¾ Combination chemotherapy with cisplatin and etoposide z F/u: died from multiple metastasis after a few months

3. Discussion

z Lung cancer:

¾ The most common cancer in the world

¾ Approximately 170000 deaths per year in U.S.

¾ Poor prognosis, only10~15% of patients survive 5years or longer.

¾ Histological subtypes:

Squamous cell carcinoma

Small cell carcinoma

Large cell carcinoma

Adenocarcinoma

¾ Cigarette smoking cause most lung cancer, but the proportion is lower for adenocarcinoma than other types

¾ Lung cancer commonly metastasizes to the liver, adrenal glands, bones and kidney.

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口腔病理科 On-Line KMU Student Bulletin

z Article review of metastatic malignant tumors of TMJ

¾ Primary tumor site was the lung in nine cases, the breast in nine cases, the prostate in five cases, and the liver, uterus, colon and pancreas in one case each. Six cases were unknown.

¾ Isolated nature of its blood supply.

¾ Breast cancer as the primary tumor is most frequent, followed by lung cancer.

題號題目

1 有關於肺癌的下列敘述何者為錯?

(A) 世界上比率最高的癌症

(B) 多半轉移到肝,腎上腺,骨頭以及腎臟

(C) 組織學上可以分為四種subtype: Squamous cell carcinoma、Small cell carcinoma、Large cell carcinoma、adenocarcinoma

(D) 所有subtype都是吸煙者較不吸煙者比例來的高

答案 (D)

出處：Oral Oncology Extra 2006;42:225

Cigarette smoking causes all types of lung cancer, but the proportion of cases attributable to smoking is lower for adenocarcinoma than for other types, due to a higher proportion of nonsmokers.

題號題目

2 關於TMJ癌症的下列敘述何者為對?

(A) 由其他部位癌症轉移的機率很高

(B) 轉移機率主要受其血液供應系統影響

(C) 由肝、腎轉移為最多

(D) 由肺、肝轉移為最少

答案 (A)

出處：Oral Oncology Extra 2006;42:225

The rarity of metastasis to the TMJ can be explained by the isolated nature of its blood supply.

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