从肺癌到口腔和头部和颈部的转移通常很少发生,并且通常在疾病的晚期阶段出现。甚至更罕见,它们是未知转移性疾病的第一个迹象。然而,它们的发生总是对临床医生来说都是一个具有挑战性的情况,在处理非常不寻常的病变时,对于病理学家来说,在识别主站点时。我们回顾性研究了21例肺癌向头颈部转移的病例(16例男性和5例女性,年龄范围43-80岁;8例局限于牙龈[其中2例发生在种植体周围牙龈],七个到下颌下淋巴结,两个到下颌骨,三个到舌头,腮腺1例,8例,转移是隐匿性肺癌的第一个临床表现),并提出了一个广泛的免疫组织化学小组,用于正确识别原发性肿瘤的组织型,包括CK5/6、CK8/18、CK7、CK20、p40、p63、TTF-1、CDX2、嗜铬粒蛋白A、突触素,GATA-3,雌激素受体,PAX8,PSA。此外,我们从以前发表的研究中收集数据,并对相关文献进行了述评.
Metastases from lung cancer to the oral cavity and to the head and neck generally are very infrequent and usually manifest in advanced stages of the disease. Even more rarely, they are the first sign of an unknown metastatic disease. Nevertheless, their occurrence always represents a challenging situation both for clinicians, in the management of very unusual lesions, and for pathologists, in the recognition of the primary site. We retrospectively studied 21 cases of metastases to the head and neck from lung cancer (sixteen males and five females, age range 43-80 years; eight cases localized to the gingiva [two of these to the peri-implant gingiva], seven to the sub-mandibular lymph nodes, two to the mandible, three to the tongue, one case to the parotid gland; in eight patients, metastasis was the first clinical manifestation of an occult lung cancer) and proposed a wide immunohistochemical panel for a proper identification of the primary tumor histotype, including CK5/6, CK8/18, CK7, CK20, p40, p63, TTF-1, CDX2, Chromogranin A, Synaptophysin, GATA-3, Estrogen Receptors, PAX8, PSA. Furthermore, we collected data from previously published studies and narratively reviewed the relevant literature.