Metastatic tumors in the oral region are relatively rare, being only 1-2% of the overall oral malignancy spectrum. Recently we experienced a case of maxillary carcinoma metastasized from the breast.
A 52-year-old woman was referred to the Department of Oral Surgery of our hospital with the chief complaint of swelling in the right submandibular region. A radical mastectomy for breast carcinoma had been performed one year previously.
Intraoral examination revealed a large soft tumor extending from the right maxillary molar alveolar ridge to the hard palate. Its surface was gray, irregular and bled on slight trauma. Roentgenogram showed destruction of the right molar alveolar ridge in the maxilla.
Intraoral biopsy was performed and histologic features of this specimen were identical to those of the breast carcinoma. That the maxillary tumor had metastasized from breast carcinoma was suggested.
In addition, we compared the phenotype of primary breast carcinoma with metastatic maxillary tumor by immunohistochernical and histochemical methods. In the immunohistochemical study, monoclonal antibody to human epithelial membrane antigen (EMA), to human lung adenocarcinoma (KM 93), and to human stomach adenocarcinoma (KNI 231) were applied. In the histochemical study, peanut agglutinin (PNA) was adopted.
In consequence, there was a marked difference in a degree of positively stained tumor cells with regard to EMA and PNA staining. The finding suggested presence of tumor cells having highly metastatic potential in the primary tumor.
