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Metastatic thyroid carcinoma of the mandible

The preponderannce of secondary mandibular tumors are carcinomas originating from primary sites in the breast, lung prostate and kidney. The thyroid gland as the primary site, involvement of the jaws are relatively rare. Although thyroid carcinoma may not be recognized at the primary site, thyroid carclinoma often metastasize to bone and visceral organs and manifest themselves initially at the metastatic sites. The common symptoms are pain, swelling and tooth mobility. To detect metastatic lesion, bone scans are more sensitive in the detection of osteoactivity and pinpoint metastases long before they are apparent on radiographs. Metastatic thyroid carcinomas are generally osteolytic, possessing an irregular indistinct scalloped margin and altered trabeculation. Thyroid carcinoma metastasizes most commonly to the lung nd bone, the mandible rater than maxilla is the usual metastatic site, owing to its much higher incidence of retained embryoinc red bone marrow cells and affects elderly female patients more frequently The hematogenous route is most often involved, either by way of the systemic circulation or through the paravertebral plexus (Batson s) of veins. Therapy for the metastatic site generally consists of surgical resection, radioactive jodine(I131)or external beam radiations. In this case we treat the metastatic thyroid carcinoma to the mandible by block resection with good result.