967P Metastases harbored in the maxillofacial region: A retrospective review of patient and tumour characteristics

Abstract

Maxillofacial metastases from distal primary sites are rare, accounting for less than 1% of all newly diagnosed cancer in the head and neck region. Clinical manifestation is non-specific and lesions are often misdiagnosed as benign or inflammatory conditions. The purpose of this study was to thoroughly describe cases of maxillofacial metastases, evaluating both patient and tumor characteristics, and to explore associations with treatment delivered. In this retrospective review, we collected data from the hospital registry of patients diagnosed with cancer in the maxillofacial region over a ten year period (from 2008 to 2018). Patients with a metastatic lesion that was supported radiologically and verified histologically were included in the study. Our initial cohort included 350 patients diagnosed with cancer in the maxillofacial region. Of these, 10 patients (7 men, 3 women) were shown to have metastatic lesions. Mean patient age was 60.7 and ranged between 48 to 73. Presenting symptoms included trismus and masseteric hypertrophy in 40% of cases. Primary malignancies most commonly originated in the lung, breast, and prostate, respectively, and the majority (80%) of tumors were adenocarcinomas. Non of these metastases were the presenting lesion of a systemic cancer. Tumors were more frequently located in the mandible than other maxillofacial sites (50%), and appeared in both bony and soft tissue regions. Radiological changes to the periosteum were most commonly observed. In 20% of cases, treatment was delayed due to misdiagnoses as acute infection or osteomyelitis. Suggestive clinical presentation should alert a physician to a potential metastatic lesion in the head and neck region, and prompt a biopsy procedure. Misdiagnosis may lead to delayed or missed treatment, whereas timely management promotes improved patient outcomes.