Metastatic tumors to the jaws : A report of eight new cases

Purpose: The purpose of the article is to present 8 new cases of metastatic tumors occurring in the jawbones, their clinical features , diagnostic workup and management. Patients and methods: The records of 8 patients with metastatic jaw lesions were reviewd. Demographic data, presenting symptoms, primary tumor site, radiographic findings, bone scintigraphy , histopathology and clinical management were analyzed. Results: The patients , ranged in age from 44 to 80 years, with a mean of 64.5 years. The primary malignant sites were: the lung , the breast , the rectum, the thyroid, the uterus and the parotid gland . The mandible was the site of oral involvement in seven cases and the maxilla in one. There was no gender difference with respect to the oral site affected. The clinical jaw presentations were: exophytic soft tissue mass, paresthesia of the lower lip and a periapical lesion The provided treatment protocols were: chemotherapy , radiotherapy and chemotherapy, surgery and chemotherapy and supportive care only. In one case the jaw lesion was the first indication of an unknown malignancy at a distant primary site. Conclusions: Metastatic jaw lesions are uncommon. Paresthesia of the lower lip and the chin is a sinister sign for patients with a metastatic jaw lesion. In view of these cases it can be said that meticulous work-up of of jaw lesions suspected of being metastatic, may be life saving or extend the patient?s survival period

Metastastatic Lesion to the Mandible: The Use of Cytogenetics

Postaviti dijagnozu metastatske lezije mandibule velik je izazov, a temelj se nalazi poglavito u histopatologiji. Rijetkima se smatraju udaljene metastaze adenokarcinoma bazalnih stanica (AKBS) u mandibuli iz tumora žlijezda slinovnica. Prijavljen je slučaj mandibularne metastaze AKBS-a iz parotidne žlijezde. Opisana je primjena citogenetike u postavljanju dijagnoze. Citogenetska se analiza može koristiti i kao dodatni postupak u dijagnosticiranju metastaza i preporučuje se kod suspektne metastatske lezije čeljusti.The diagnosis of metastatic lesion to the jaws is difficult, challenging and is based mainly on histopathology. Distant metastasis of basal cell adenocarcinoma (BCAC) to the mandible from salivary gland tumor is considered rare. A case of mandibular metastasis from parotid BCAC is reported. The use of cytogenetics in the diagnostic work-up is described. Cytogenetic analysis may be used as an additional tool for diagnosis of metastases and is recommended when a metastatic jaw lesion is suspected

Harnessing Soluble NK Cell Killer Receptors for the Generation of Novel Cancer Immune Therapy

The natural cytotoxic receptors (NCRs) are a unique set of activating proteins expressed mainly on the surface of natural killer (NK) cells. The NCRs, which include three members; NKp46, NKp44 and NKp30, are critically involved in NK cytotoxicity against different targets, including a wide range of tumor cells derived from various origins. Even though the tumor ligands of the NCRs have not been identified yet, the selective manner by which these receptors target tumor cells may provide an excellent basis for the development of novel anti-tumor therapies. To test the potential use of the NCRs as anti-tumor agents, we generated soluble NCR-Ig fusion proteins in which the constant region of human IgG1 was fused to the extracellular portion of the receptor. We demonstrate, using two different human prostate cancer cell lines, that treatment with NKp30-Ig, dramatically inhibits tumor growth in vivo. Activated macrophages were shown to mediate an ADCC response against the NKp30-Ig coated prostate cell lines. Finally, the Ig fusion proteins were also demonstrated to discriminate between benign prostate hyperplasia and prostate cancer. This may provide a novel diagnostic modality in the difficult task of differentiating between these highly common pathological conditions

Expression of Ligands to NKp46 in Benign and Malignant Melanocytes

Human melanoma cell lines were shown to express ligands for the natural cytotoxicity receptor, NKp46, expressed by natural killer (NK) cells. We aimed to examine the expression of ligands for NKp46 by various primary human melanocytic cells and melanocytic lesions. Sections from primary nevi and melanomas were tested for expression of NKp46 ligands employing chimeric NKp46-Fc for staining. The melanocytes present in the reticular dermis were negative for NKp46 ligands in common nevi; in malignant melanocytic lesions, the deeper melanocytes were focally positive. In dermoepidermal junction of all melanocytic lesions, the melanocytes showed enhanced expression of NKp46 ligands. Melanophages in all lesions were consistently positive for NKp46 ligands. These observations establish the expression of NKp46 ligands by primary-transformed melanocytes. Normal melanocytes did not express ligands to NKp46. Therefore, the results show (i) a correlation between the malignant potential of the lesion and the expression of NKp46 ligands in the reticular dermis, and (ii) enhanced expression of NKp46 ligands in the active proliferation zone (dermoepidermal junction) of nevi and melanomas. Ligands to NKp46 were expressed on the membrane and within the cells. The physiological role of NKp46 ligands in the progression of malignancy within melanocytic lesions should be explored further

Impaired access of lymphocytes to neoplastic prostate tissue is associated with neoangiogenesis in the tumour site

Recent reports demonstrated that neovasculature of certain murine tumours inhibits migration of lymphocytes to malignant tissues. We examined the possible existence of this phenomenon in human prostate adenocarcinoma by relating extent, patterns and composition of leucocyte infiltrates in adenocarinoma specimens (N=28) to microvessel density and percentages of these vessels expressing adhesion molecules CD54, CD106 and CD62E. Specimens of nodular hyperplasia (N=30) were used as a control for nonmalignant prostate. Increased microvessel density was detected in foci of adenocarcinoma, as compared with adjacent benign areas (P=0.004) or hyperplastic specimens (P=0.001). Only CD54 was detected on prostate vasculature; percentages of CD54-expressing vessels in adenocarcinoma lesions and adjacent areas were higher than in hyperplasia (P=0.041 and P=0.014, respectively). Infiltrating leucocytes were either scattered diffusely in tissue or organised into clusters mainly composed of CD4-positive lymphocytes; smaller percentage of tissue was occupied by clustered infiltrates in adenocarcinoma foci (mean=0.7; median=0; range=0–5) than in adjacent tissue (mean=2.5; median=1; range=0–15; P=.021) and hyperplasia (mean=1.9; median=2; range=0–5; P=.006). In adenocarcinoma foci, microvessel density tended to negatively correlate with percentage of tissue occupied by an overall leucocyte infiltrate (mean=8.6; median=7.5; range=30) and negatively correlated with percentage of tissue occupied by clustered infiltrate (P=0.045). Percentage of CD54-expressing vessels positively correlated with percentage of tissue occupied by an overall (mean=12; median=10; range=30; P=0.01) and clustered (P=0.023) infiltrate in hyperplasia, whereas in carcinoma-adjacent benign areas, correlation was detected only for clustered infiltrates (P=0.02). The results indicate that impaired access of lymphocytes to malignant lesions is associated with increased numbers of newly formed blood vessels, whereas vascular CD54 likely contributes to extravasation of lymphocytes only in benign prostate tissue

Metastastatic Lesion to the Mandible: The Use of Cytogenetics

Postaviti dijagnozu metastatske lezije mandibule velik je izazov, a temelj se nalazi poglavito u histopatologiji. Rijetkima se smatraju udaljene metastaze adenokarcinoma bazalnih stanica (AKBS) u mandibuli iz tumora žlijezda slinovnica. Prijavljen je slučaj mandibularne metastaze AKBS-a iz parotidne žlijezde. Opisana je primjena citogenetike u postavljanju dijagnoze. Citogenetska se analiza može koristiti i kao dodatni postupak u dijagnosticiranju metastaza i preporučuje se kod suspektne metastatske lezije čeljusti.The diagnosis of metastatic lesion to the jaws is difficult, challenging and is based mainly on histopathology. Distant metastasis of basal cell adenocarcinoma (BCAC) to the mandible from salivary gland tumor is considered rare. A case of mandibular metastasis from parotid BCAC is reported. The use of cytogenetics in the diagnostic work-up is described. Cytogenetic analysis may be used as an additional tool for diagnosis of metastases and is recommended when a metastatic jaw lesion is suspected