■胆管癌是一种恶性肿瘤,诊断困难,预后不良,可出现在胆道树的任何地方。解剖学上,它可以分为肝内或肝外,后者是胆道最常见的原发性恶性肿瘤。尽管骨组织通常是转移的第三大常见靶标,胆管癌的转移性病变在头颈部并不常见。
方法:一名因胆管癌而接受癌症治疗的33岁女性患者被转诊至位于PassoFundo的圣保罗医院的口腔颌面外科和创伤服务(CTBMF),南里奥格兰德州,巴西,跨学科的后续行动。她出示了刺耳,吞咽困难,疼痛,脑区的坏死和引流,以及在牙齿47和48的区域中的下颌体的右侧上的增加的体积。在该凸出区域进行了切开活检。病理诊断为低分化癌。CTBMF团队每周对患者进行随访,接受口内外病变的镇痛和姑息治疗,控制机会性感染,改善食物摄入。
结论:下颌骨转移性胆管癌少见,因此,他们的诊断往往很晚,这可能不利于这些疾病的预后。
结论:强烈建议仔细检查下颌骨病变患者,尤其是已知或先前合并恶性肿瘤的患者。
UNASSIGNED: Cholangiocarcinoma is a malignant neoplasm with a difficult diagnosis and unfavorable prognosis that can appear anywhere in the biliary tree. Anatomically, it can be classified as intra- or extrahepatic, the latter being the most common primary malignancy of the biliary tract. Although bone tissue is the third most common target for metastases in general, metastatic lesions from cholangiocarcinomas are uncommon in the head and neck.
METHODS: A 33-year-old female patient undergoing cancer treatment for cholangiocarcinoma was referred to the Oral and Maxillofacial Surgery and Traumatology Service (CTBMF) of the São Vicente de Paulo Hospital in Passo Fundo, Rio Grande do Sul, Brazil, for interdisciplinary follow-up. She presented trismus, dysphagia, pain, necrosis and drainage in the mental region, and an increased volume on the right side of the mandibular body in the region of teeth 47 and 48. An incisional biopsy was performed in this bulging region. The histopathological diagnosis was poorly differentiated carcinoma. The patient was followed-up weekly by the CTBMF team, receiving analgesia and palliative treatment for the extra- and intraoral lesions, controlling opportunistic infections, and improving food intake.
CONCLUSIONS: Metastatic cholangiocarcinomas in the mandible are rare, hence their diagnosis is often late, which may disfavor the prognosis of these conditions.
CONCLUSIONS: Carefully examining patients with mandibular bone lesions is strongly suggested, especially patients with known or previous concomitant malignancy.