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An Official Publication of the Indian Association of Oral and Maxillofacial Pathologists


 
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ONLINE ONLY ARTICLES - CASE REPORT  
Year : 2022  |  Volume : 26  |  Issue : 1  |  Page : 133
 

Mandibular metastasis of follicular thyroid carcinoma: A case report along with the concise review of literature


1 Department of Oral Pathology, Microbiology and Forensic Odontology, Laxmi Bai Institute of Dental Sciences and Hospital, Patiala, Punjab, India
2 Department of Oral and Maxillofacial Surgery, Guru Nanak Dev Dental College and Research Institute, Sunam, Punjab, India
3 Department of Oral Pathology, Microbiology and Forensic Odontology, Rayat and Bahra Dental College and Hospital, Mohali, Punjab, India

Date of Submission23-Sep-2021
Date of Decision04-Oct-2021
Date of Acceptance24-Nov-2021
Date of Web Publication31-Mar-2022

Correspondence Address:
S Gupta
H. No. 95/3, Adarsh Nagar, Dera Bassi, Dist: Mohali, Punjab
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jomfp.jomfp_408_21

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   Abstract 


Metastasis is one of the most common consequences of malignant tumors, and it is one of the leading causes of morbidity and mortality. Metastatic cancers to oral cavity are extremely rare. Moreover, the true incidence has yet to be determined. Despite their rarity, they are important clinically, since they can be the first and the only evidence of spread in many situations. Breast, kidney, lung, prostate and gastrointestinal tract are the most common sources of metastases in the oral cavity. Thyroid carcinoma is the most prevalent type of endocrine cancer, yet it rarely spreads to the oral cavity. After papillary thyroid carcinoma, follicular thyroid carcinoma is the second-most frequent kind of thyroid cancer. Jawbones are more commonly affected than soft tissues. Literature research revealed that till date, 44 cases of metastatic follicular thyroid cancer to the jawbones have been documented with mandibular preponderance (40 cases). With the rising occurrence of oral metastatic tumors in recent years, it has become increasingly important to diagnose them early to avoid future consequences. We present here an unusual case of metastatic follicular thyroid cancer in the mandible of an elderly adult along with a comprehensive review of the literature.


Keywords: Carcinoma, follicular, mandible, metastatic, thyroid


How to cite this article:
Jawanda M K, Narula R, Gupta S, Gupta P. Mandibular metastasis of follicular thyroid carcinoma: A case report along with the concise review of literature. J Oral Maxillofac Pathol 2022;26:133

How to cite this URL:
Jawanda M K, Narula R, Gupta S, Gupta P. Mandibular metastasis of follicular thyroid carcinoma: A case report along with the concise review of literature. J Oral Maxillofac Pathol [serial online] 2022 [cited 2022 Dec 3];26:133. Available from: https://www.jomfp.in/text.asp?2022/26/1/133/341410





   Introduction Top


Cancer is a complicated disease in which several basic processes are disrupted, including cell proliferation, death and cell migration.[1] Metastasis is the transfer of malignant tumor cells from their main site of genesis to distant areas, resulting in their colonization.[2] It causes morbidity and eventually death.[3] Metastatic tumors in the oral cavity are extremely rare, accounting for only 1%–2% of all cancers.[4] The breast, lung, kidney, prostate and gastrointestinal tract (GIT) are the most common main sites, and it affects both men and women.[5] Thyroid cancer is the most prevalent type of cancer in the overall endocrine system, and follicular thyroid carcinoma (FTC) is the second-most common type.[6] It generally spreads to the lungs and bones, and rarely to the oral cavity.[7] The jaw bone is more commonly implicated in the oral cavity than the oral mucosa.[8] And the mandible is affected more frequently than the maxilla.[9] Literature search reveals that 40 cases of metastatic FTC to the mandible have been recorded till date [Table 1]. We present another unusual case of metastatic follicular thyroid cancer (FTC) to the mandible in an elderly male patient along with the concise review of cases published in the literature till date.
Table 1: Cases of follicular thyroid carcinoma metastasizing to jaw bone reported till date in the literature#

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   Case Report Top


A 55-year-old male patient reported with swelling on the right side of the body of the mandible for the past 4–5 months associated with no pain and no obvious cervical lymphadenopathy. Intra-oral examination showed the presence of swelling in the right mandibular region [Figure 1]a. The patient had given no relevant medical history. Serum thyroglobulin's (Tg) levels were markedly elevated with the value of 1423.00 ng/ml (normal value-1.6–60 ng/ml) while serum T3, T4 and TSH levels were within the normal range.
Figure 1: (a) Clinical photograph showing swelling in the posterior right-side lingual vestibule. (b) Photograph of gross incisional tissue

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Radiographic images revealed an osteolytic lesion in the mandibular right 44 to 47 region, which was round to oval and uncorticated along with thinning of the lower border on the same side with intervening radiopaque septae in the radiolucency [Figure 2]a. Computerized tomography (CT) scan showed an expansile destructive bony lesion involving the body of the mandible in the region of 44 till 47. The tumor caused expansion and perforation of both buccal and lingual cortical plates resulting in bulging of the tumor mass [Figure 2]b. CT scan also showed one enlarged level I b lymph node.
Figure 2: (a) Panoramic radiograph of patient showing a lytic lesion. (b) Computed tomography scan of the patient showing a lytic lesion with resorption of buccal and lingual cortical plates of the right-side posterior mandible

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Based on clinical and radiological findings, provisional diagnosis of Ameloblastoma and Central Giant Cell Granuloma (CGCG) was made.

Incisional biopsy [Figure 1]b was performed and tissue was sent for histopathological examination. Hematoxylin and eosin (H and E) stained histopathological section revealed the presence of well-developed duct-like structures and numerous round to oval follicles lined by a single layer of cuboidal to low columnar epithelial cells. The lumen of follicles contained eosinophilic colloid-like material [Figure 3]a. Follicles and colloid-like material also showed positivity with periodic acid Shiff (PAS) staining [Figure 3]b. Tumor cells in areas formed macrofollicular patterns along with microfollicles [Figure 4]a and [Figure 4]b. The trabecular and solid patterns of follicles were also present in few areas with tumor cells exhibiting mild pleomorphism and hyperchromatism [Figure 5]a and [Figure 5]b. Stromal hyalinization was also seen [Figure 6]a and [Figure 6]b. Based on histopathological findings, diagnosis of metastatic FTC to mandible was made. Immunohistochemical analysis (IHC) revealed that the tumor cells were immunopositive for Tg, thyroid transcription factor-1 (TTF-1) and paired box gene 8 (Pax8) and immunonegative for S100 protein and Calretinin [Figure 7]. The patient was referred to an oncologist for further management. Before publishing this paper, the patient's consent was obtained.
Figure 3: (a) Photomicrograph showing numerous round to oval follicles lined by a single layer of cuboidal to low columnar epithelial cells, containing eosinophilic colloid like material in the lumen (H&E stain, ×400) (b) photomicrograph showing colloid material to be weakly Pas positive (Per iodic Acid Schiff stain, ×400)

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Figure 4: (a) Tumor cells forming macrofollicular and microfollicular pattern (H and E stain, ×100) (b) (H&E stain, ×400)

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Figure 5: (a) Photomicrograph showing the trabecular and solid pattern of follicles with tumor cells exhibiting pleomorphism and hyperchromasia (H&E stain, 100x) (b) (H&E stain, ×400)

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Figure 6: (a) Photomicrograph showing stromal hyalinization (H&E stain, ×100) (b) (H&E stain, ×400)

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Figure 7: Immunopositivity for thyroglobulin, thyroid transcription factor-1 and Pax 8 and tumor cells are immunonegative for S100 and calretinin (×400)

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A comprehensive review of the English literature was performed using PubMed, Medline, Embase and Scopus databases. Papers describing FTC as a metastatic lesion in the jawbones were selected including terms: “thyroid,” “cancer,” “thyroid carcinoma,” “thyroid cancer,” “Follicular,” “Follicular thyroid carcinoma,” “metastasis,” “malignancy” with “oral cavity,” “maxilla,” and “mandible,”. Reports involving metastasis to the soft tissues and other facial structures were excluded. Data were extracted and compiled in a table. Data points obtained from the literature review included authors names and year of publication, age of patients, gender, primary histological diagnosis, site of metastasis, clinical presentation, time to metastasis, treatment modality, survival outcome [Table 1].


   Discussion Top


Metastatic cancers to oral cavity are extremely rare and the true incidence is unknown.[4] According to the literature, these lesions account for only 1% of all oral cancers. They are frequently neglected in diagnosis due to their rarity for the following reasons: [10]

  1. They are similar to squamous cell carcinoma, the most frequent malignant tumor of the jaw
  2. The lesions are positioned in the center of the bone
  3. Except in the most advanced stages, the patient has little subjective symptoms.


However, it is possible that the seeming rarity is due in part to a failure to diagnose metastatic malignancies in the jaws. Furthermore, because the jaws are not frequently inspected at autopsy, some abnormalities may be missed. As a result, the true incidence of metastatic cancers in the jaws may be higher.[11] These tumors, on the other hand, maybe of important clinical significance since, as in many cases, their presence may be the only symptom of an undiagnosed underlying malignancy or the first evidence of the recognized tumor's dissemination from its originating site.[12] Most of the cases, reported in the literature had oral metastasis as the first symptom of the disease. Anil et al. in 1999[13] documented a case with evidence of metastasis after 8 years, Rohilla et al. in 2011 provided a case with evidence of metastasis after 2 years,[11] Narain and Batra in 2011[14] and Kotina et al. in 2013[15] described a case with evidence of metastasis after 15 years. Vazifehmostaan et al. in 2013 described a case in which metastasis took 12 years.[4] After 1 year of thyroidectomy, evidence of metastases was found, according to Sathyanarayanan et al. in 2019.[16]

Breast, lung, kidney, prostate and GIT are the most common primary sites.[17],[18] And the prevalence is different for both men and women.[11] Breast cancer is the most prevalent cause of metastatic oral cancer in women, whereas lung cancer, followed by prostate cancer, is the most common cause in men.[19] The most common site of metastasis to the oral soft tissues is the lung, while the most common site of metastatic cancers to the jawbones is the breast.[20]

Though thyroid cancer is the most frequent in the endocrine system,[21] it rarely spreads to the oral cavity.[22] Papillary, follicular, medullary and anaplastic thyroid carcinomas are its four histological variations.[23],[24],[11] While papillary and follicular variations are widely defined, readily curable, and usually have a favorable prognosis, FTC is more aggressive than papillary variant due to a mutation in the p21 Ras oncogene.[25],[26] Distant metastases have been detected in 10%–15% of FTC patients. After the lungs, bone metastasis is the second most prevalent place.[27] The most common route of transmission is hematogenous, however, lymphatic spread is also preferable.[7]

Although the molecular basis for distant metastasis of thyroid cancer is unknown, current research suggests that embryonic processes involved in cell movements, such as epithelial to mesenchymal transition and collective cell motility, may be reactivated.[28]

The jaw bone is more commonly affected by these metastatic cancers than the oral mucosa.[8] The Mandible is more commonly affected than the maxilla in the jaw bone, with the body of the mandible, particularly the premolar-molar region, being the most commonly affected region.[9] This is due to the presence of rich red marrow and increased trapping of metastatic cells due to sluggish blood flow regulation in this region.[29] In addition, this marrow contains growth factors that may help some metastatic cancers colonize.[30] However, compared to other skeletal bones in the body, the jaw bone has a lower overall incidence of metastasis, which is likely due to the gradual replacement of red marrow by yellow or fatty marrow.[31] In our assessment of the literature, we found 44 cases with FTC metastasizing to the jaw bone. Out of them, 40 cases included the mandible, while just four cases involved the maxilla [Table 1]. It was discovered that the metastasis had primarily spread to one side of the jaw. Kim et al. in 2013 described one case in which the mandible was involved bilaterally.[7] The site of involvement in our case is also the mandible, which supports the same findings as shown in the numerous cases previously published, as shown in [Table 1]. FTC affects people in their forties and fifties, with a female predominance and a female: male ratio of 3.3:1.[24] There have been extremely few occurrences of FTC involving males in the published data. Out of 44 cases, 34 involved females and only 10 involved males [Table 1] and the average age of incidence was 58 years. This gender disparity could be attributable to the fact that males and females have distinct hormones. Infertility, irregular menstrual cycles, miscarriage, multiple pregnancies or live births, lactation suppressants, oral contraceptives and other non-contraceptives, and estrogens are all linked to an increased risk of thyroid cancer in women.[32] An unusual case of metastatic follicular carcinoma of the thyroid in an elderly man patient is presented in our case. Pain, swelling, loosening of teeth, and paresthesia are all common clinical signs in patients who are generally asymptomatic.[17] This tumor appears as a solitary nodule, a multinodular goiter or cervical lymphadenopathy at first.[23]

Mandibular metastasis can mimic other inflammatory conditions including periodontitis, periapical lesions or osteomyelitis, thus clinicians should be aware of these lesions. A primary oral soft -tissue malignancy with osseous invasion, as well as a second primary malignant mandibular bone lesion, should be examined with the appropriate medical history.[9]

Draper et al. in 1979[33] and Krishnamurthy et al. in 2016[12] both documented ulceration in their patients. A patient with a progressively growing vascular lesion was documented by Osguthorpe et al. in 1982.[34] In 1984, Tovi et al. described a lesion that looked like an AV malformation.[35] The growth, which resembled an odontogenic tumor, was described by Al Sheddi et al. in 2015[36] and Vishveshwaraiah et al. in 2013.[13] In a case reported by Saha et al. in 2016, the patient also had shortness of breath for a month.[37] Another observation in the patient, according to Algahtani et al. in 2009, was pathological fracture.[31] Herein our case, the patient had no symptoms, no discomfort, no tooth loss or paraesthesia, and no visible cervical lymphadenopathy. FTC is occasionally associated with hoarseness of voice and neck pain,[23] but the majority of cases recorded in the literature indicated no such history, with the exception of Zandi et al. in 2014[38] and Kori et al. in 2015.[5] No such symptom was found in our case.

Fine-needle aspiration cytology, histology, X-ray, CT scan, magnetic resonance imaging, ultrasound, thyroid scan, serum thyroid profile and immunohistochemistry are all used to diagnose FTC. The histopathology of FTC might range from well differentiated to poorly differentiated. The microfollicular architecture is preserved in the well-differentiated tumor, which has follicles bordered with cuboidal cells containing an eosinophilic colloid-like substance. These characteristics of a well-differentiated tumor are associated with a favorable prognosis. Solid development, the absence of follicles, prominent nuclear atypia and substantial vascular and/or capsular invasion are all characteristics of poorly differentiated lesions, and these characteristics are linked to a worse prognosis.[23] Both follicular cells and colloid particles are stained positive with PAS.[39] In this case, radiographic examination revealed the involvement of the right mandible's body, as well as buccal and cortical plate expansion. When the clinical and radiographic findings were compared, the first provisional diagnosis made was either Ameloblastoma or CGCG. Because the findings matched the characteristics of these two lesions. However, based on the histological findings, Ameloblastoma was ruled out because there was no stellate reticulum between the follicles. And the lack of large cells indicated that the lesion was not CGCG. A final diagnosis of metastatic FTC was accorded since the histological picture in the present case showed the features of FTC. Tissue was sent for IHC examination to confirm our diagnosis. The pathologist employed a variety of markers to distinguish the lesion from other possible preliminary diagnoses. Tg, TTF-1, PAX8, Calretinin and S-100 were among them.

The most specific histogenetic markers for FTC are Tg, TTF-1 and PAX8. Other markers, include Galectin-3 (GAL-3), CD44, oncofetal fibronectin, telomerase, and high mobility group protein. RET/p56 rearrangement, have also been reported, but their efficacy has not been demonstrated.[40],[41],[42]

TTF-1 is a transcription factor that regulates thyroid-specific transcription of the Tg gene.[43] PAX8 is a transcription factor from the paired box (PAX) family that is expressed during thyroid gland organogenesis.[44] TTF-1 has shown to be expressed only in normal thyroid follicular cells and a few C cells in thyroid C-cell hyperplasia and thyroid neoplasms, including 100% of cases of FTC, according to studies.[40] PAX8 expression has been found mostly in thyroid and renal neoplasms, with a few cases in the bladder.[45] PAX8 expression in thyroid neoplasms was studied in several studies, with a positive rate of roughly 91%–100% in all FTCs. In our case, tumor cells showed immunopositivity with Tg, TTF-1 and PAX8 and immunonegativity with Calretinin and S-100.

Calretinin is a marker used to identify odontogenic tumors such as ameloblastoma and Keratocystic odontogenic tumor.[46] S-100 has been found to be immunopositive in cases of plexiform ameloblastoma, particularly in the stellate reticulum area, in numerous studies.[47] Because both markers were immunonegative in our case, it was a strong confirmation to rule out Ameloblastoma as a provisional diagnosis. Even though serum Tg levels are not diagnostic of clinical condition, they can rise as follicular cells grow, as in goiter and thyroiditis.[48] Serum Tg concentrations may rise dramatically in patients with a significant tumor burden, such as those with first distant metastases.[49] In our case, the same results were reported. Serum Tg levels were shown to be high in individuals with Metastatic FTC in many cases described in the literature.[50] In a patient with metastatic FTC to the mandible, Vishveshwaraiah et al. reported a serum Tg level of 480 ng/ml in 2013.[13] Thyroidectomy, radiation, chemotherapy, hemi mandibulectomy, resection and segmental mandibulectomy are all options for FTC treatment. Every case has a distinct survival rate, with the majority of cases displaying no signs of disease. Thyroid crisis kills a small percentage of patients, as shown in [Table 1]. A poor prognosis is linked to the existence of distant metastases. A 10-year survival rate of 27% has been observed for bone metastases of differentiated thyroid cancer. After 5 years, Brennan et al. found that 40% of patients with distant follicular metastases survived. Although oral cavity metastatic tumors are uncommon, early diagnosis of the metastatic disease improves overall survival and treatment outcomes.


   Conclusion Top


Metastatic FTCs are critical because they might be the only indication of an undiagnosed underlying malignancy at a distant site, with metastatic lesions being the first or only clinical manifestation. The diagnosis of a metastatic lesion in the oral region is difficult, both for the physician and the pathologist, due to its rarity. Recognizing that a lesion is metastatic and determining the site of metastatic spread is difficult. This case report adds to the growing list of rare examples of distant metastases of FTC to the mandible, emphasizing the importance of clinician attentiveness and knowledge while dealing with such situations.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient (s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initial s will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

Abbreviations used

CGCG: Central Giant Cell Granuloma, CT: Computerized tomography, FTC: Follicular thyroid carcinoma, GIT: gastrointestinal tract, H-E: Hematoxylin and Eosin, IHC: Immunohistochemical analysis, PAS: Periodic acid shiff, Pax: Paired box gene, Tg: thyroglobulin, TTF-1: Thyroid transcription factor.[71]



 
   References Top

1.
Kreeger PK, Lauffenburger DA. Cancer systems biology: A network modeling perspective. Carcinogenesis 2010;31:2-8.  Back to cited text no. 1
    
2.
Steeg PS. Targeting metastasis. Nat Rev Cancer 2016;16:201-18.  Back to cited text no. 2
    
3.
Noguti J, De Moura CF, De Jesus GP, Da Silva VH, Hossaka TA, Oshima CT, et al. Metastasis from oral cancer: An overview. Cancer Genomics Proteomics 2012;9:329-35.  Back to cited text no. 3
    
4.
Vazifeh Mostaan L, Irani S, Rajati M, Memar B. Mandibular metastasis from follicular thyroid carcinoma: A rare case after twelve years. Arch Iran Med 2013;16:557-9.  Back to cited text no. 4
    
5.
Kori CG, Vishnoi JR, Rajan S, Malhotra KP, Gupta S, Kumar V. Mandibular Metastasis in Patients of Follicular Thyroid Carcinoma: A Rare Entity; Report of Two Cases. -. International Journal of Health Sciences and Research 2015; 5: 581-5.  Back to cited text no. 5
    
6.
Khoozestani NK, Mosavat F, Shirkhoda M, Sedaghati A. Metastatic papillary thyroid carcinoma of the mandible: Case report and literature review. J Oral Maxillofac Pathol 2019;23:97-105.  Back to cited text no. 6
[PUBMED]  [Full text]  
7.
Kim DW, Hah JH, An SY, Chang H, Kim KH. Follicular thyroid carcinoma presenting as bilateral cheek masses. Clin Exp Otorhinolaryngol 2013;6:52-5.  Back to cited text no. 7
    
8.
van der Waal RI, Buter J, van der Waal I. Oral metastases: Report of 24 cases. Br J Oral Maxillofac Surg 2003;41:3-6.  Back to cited text no. 8
    
9.
Ismail SB, Abraham MT, Zaini ZB, Yaacob HB, Zain RB. Metastatic follicular thyroid carcinoma to the mandible: A case report. Cases J 2009;2:6533.  Back to cited text no. 9
    
10.
Akhtar MS, Bhargava R, Khan N, Ahmad Z, Afroz N. Metastatic mandibular adenocarcinoma. J Indian Acad Clin Med 2007;8:196-8.  Back to cited text no. 10
    
11.
Rohilla K, Ramesh V, Singh V, Sriram K. Thyroid carcinoma metastasising in the mandible: A case report. JIMSA 2011;24:189-90.  Back to cited text no. 11
    
12.
Krishnamurthy A, Deen S, Ramshankar V, Majhi U. Metastatic follicular carcinoma thyroid masquerading as a primary jaw tumor. J Maxillofac Oral Surg 2016;15:266-9.  Back to cited text no. 12
    
13.
Anil S, Lal PM, Gill DS, Beena VT. Metastasis of thyroid carcinoma to the mandible. Case report. Aust Dent J 1999;44:56-7.  Back to cited text no. 13
    
14.
Narain S, Batra H. Metastatic carcinoma of maxilla secondary to primary follicular carcinoma of thyroid gland – A case report. Indian J Dent 2011;2:30-2.  Back to cited text no. 14
    
15.
Kotina S, Kumar K, Raghunath V. Metastatic thyroid carcinoma of the mandible-mimicking paraganglioma. Oral Maxillofac Pathol J 2013;4:390-3.  Back to cited text no. 15
    
16.
Sathyanarayanan, Guna TP, Jude NJ, Monica S, Raghu K, Rilna P. Metastatic follicular carcinoma of thyroid in left mandible: A case report. J Den Max Surg 2019;2:171-6.  Back to cited text no. 16
    
17.
Irani S. Metastasis to the Jawbones: A review of 453 cases. J Int Soc Prev Community Dent 2017;7:71-81.  Back to cited text no. 17
    
18.
Hirshberg A, Leibovich P, Buchner A. Metastatic tumors to the jawbones: Analysis of 390 cases. J Oral Pathol Med 1994;23:337-41.  Back to cited text no. 18
    
19.
Shin SJ, Roh JL, Choi SH, Nam SY, Kim SY, Kim SB, et al. Metastatic carcinomas to the oral cavity and oropharynx. Korean J Pathol 2012;46:266-71.  Back to cited text no. 19
    
20.
Pasupula AP, Dorankula SP, Thokala MR, Kumar MP. Metastatic follicular thyroid carcinoma to the mandible. Indian J Dent Res 2012;23:843.  Back to cited text no. 20
[PUBMED]  [Full text]  
21.
Nguyen QT, Lee EJ, Huang MG, Park YI, Khullar A, Plodkowski RA. Diagnosis and treatment of patients with thyroid cancer. Am Health Drug Benefits 2015;8:30-40.  Back to cited text no. 21
    
22.
Kumar CS, Shanmugam D, Venkatapathy R, Munshi MA. Metastatic follicular carcinoma of thyroid in maxilla. Dent Res J (Isfahan) 2013;10:817-9.  Back to cited text no. 22
    
23.
Vishveshwaraiah PM, Mukunda A, Laxminarayana KK, Kasim K. Metastatic follicular thyroid carcinoma to the body of the mandible mimicking an odontogenic tumor. J Cancer Res Ther 2013;9:320-3.  Back to cited text no. 23
    
24.
D'Avanzo A, Treseler P, Ituarte PH, Wong M, Streja L, Greenspan FS, et al. Follicular thyroid carcinoma: Histology and prognosis. Cancer 2004;100:1123-9.  Back to cited text no. 24
    
25.
Correa P, Chen VW. Endocrine gland cancer. Cancer 1995;75:338-52.  Back to cited text no. 25
    
26.
Wright PA, Lemoine NR, Mayall ES, Wyllie FS, Hughes D, Williams ED, et al. Papillary and follicular thyroid carcinomas show a different pattern of ras oncogene mutation. Br J Cancer 1989;60:576-7.  Back to cited text no. 26
    
27.
Pittas AG, Adler M, Fazzari M, Tickoo S, Rosai J, Larson SM, et al. Bone metastases from thyroid carcinoma: Clinical characteristics and prognostic variables in one hundred forty-six patients. Thyroid 2000;10:261-8.  Back to cited text no. 27
    
28.
Vasko VV, Saji M. Molecular mechanisms involved in differentiated thyroid cancer invasion and metastasis. Curr Opin Oncol 2007;19:11-7.  Back to cited text no. 28
    
29.
Vural E, Hanna E. Metastatic follicular thyroid carcinoma to the mandible: A case report and review of the literature. Am J Otolaryngol 1998;19:198-202.  Back to cited text no. 29
    
30.
Zetter BR, Chackal-Roy M, Smith R. The cellular basis for prostate cancer metastasis. In: Karr JP, Yamanaka H, editors. Prostate Cancer and Bone Metastasis. New York: Premium Press; 1992.  Back to cited text no. 30
    
31.
Algahtani M, Alqudah M, Alshehri S, Binahmed A, Sándor GK. Pathologic fracture of the mandible caused by metastatic follicular thyroid carcinoma. J Can Dent Assoc 2009;75:457-60.  Back to cited text no. 31
    
32.
Mack WJ, Preston-Martin S, Bernstein L, Qian D, Xiang M. Reproductive and hormonal risk factors for thyroid cancer in Los Angeles County females. Cancer Epidemiol Biomarkers Prev 1999;8:991-7.  Back to cited text no. 32
    
33.
Draper BW, Precious DS, Priddy RW, Byrd DL. Clinicopathological conference. Case 29, part 2. Follicular thyroid carcinoma metastatic to the mandible. J Oral Surg 1979;37:736-9.  Back to cited text no. 33
    
34.
Osguthorpe JD, Bratton JR. Occult thyroid carcinoma appearing as a single mandibular metastasis. Otolaryngol Head Neck Surg 1982;90:674-5.  Back to cited text no. 34
    
35.
Tovi F, Leiberman A, Hirsch M. Uncommon clinical manifestations in a case of thyroid carcinoma. Head Neck Surg 1984;6:974-7.  Back to cited text no. 35
    
36.
Al Sheddi MA, Al Shgrauod R, Al Weited A, Al Sadhan R. Metastatic thyroid carcinoma to the mandible mimicking an odontogenic tumor. Oral Surg Oral Med Oral Path Oral Radiol 2015;119:e212.  Back to cited text no. 36
    
37.
Saha K, Jash D, Maji A. Mandibular metastasis with pulmonary cannon balls: Presentation of follicular carcinoma thyroid. Med J DY Patil Univ 2016;9:234-6.  Back to cited text no. 37
  [Full text]  
38.
Zandi M, Jafari M, Isapour M, Jafari AA. Mandibular metastasis in a patient with undiscovered synchronous thyroid and prostate cancer: A diagnostic dilemma. J Oral Maxillofac Pathol 2014;18:449-52.  Back to cited text no. 38
[PUBMED]  [Full text]  
39.
Tatic S. Histopathological and immunohistochemical features of thyroid carcinoma. Arch Oncol 2003;11:173-4.  Back to cited text no. 39
    
40.
Liu H, Lin F. Application of immunohistochemistry in thyroid pathology. Arch Pathol Lab Med 2015;139:67-82.  Back to cited text no. 40
    
41.
Whitley RJ, Ain KB. Thyroglobulin: A specific serum marker for the management of thyroid carcinoma. Clin Lab Med 2004;24:29-47.  Back to cited text no. 41
    
42.
Latrofa F, Ricci D, Montanelli L, Rocchi R, Piaggi P, Sisti E, et al. Lymphocytic thyroiditis on histology correlates with serum thyroglobulin autoantibodies in patients with papillary thyroid carcinoma: Impact on detection of serum thyroglobulin. J Clin Endocrinol Metab 2012;97:2380-7.  Back to cited text no. 42
    
43.
Kimura S, Hara Y, Pineau T, Fernandez-Salguero P, Fox CH, Ward JM, et al. The T/ebp null mouse: Thyroid-specific enhancer-binding protein is essential for the organogenesis of the thyroid, lung, ventral forebrain, and pituitary. Genes Dev 1996;10:60-9.  Back to cited text no. 43
    
44.
Pasca di Magliano M, Di Lauro R, Zannini M. Pax8 has a key role in thyroid cell differentiation. Proc Natl Acad Sci U S A 2000;97:13144-9.  Back to cited text no. 44
    
45.
Fabbro D, Di Loreto C, Beltrami CA, Belfiore A, Di Lauro R, Damante G. Expression of thyroid-specific transcription factors TTF-1 and PAX-8 in human thyroid neoplasms. Cancer Res 1994;54:4744-9.  Back to cited text no. 45
    
46.
Anandani C, Metgud R, Singh K. Calretinin as a diagnostic adjunct for ameloblastoma. Patholog Res Int 2014;2014:308240.  Back to cited text no. 46
    
47.
Sherlin HJ, Natesan A, Ram P, Ramani P, Thiruvenkadam C. Immunohistochemical profiling of Ameloblastomas using cytokeratin, vimentin, smooth muscle actin, CD34 and S100. Ann Maxillofac Surg 2013;3:51-7.  Back to cited text no. 47
[PUBMED]  [Full text]  
48.
McLeod DS, Cooper DS, Ladenson PW, Ain KB, Brierley JD, Fein HG, et al. Prognosis of differentiated thyroid cancer in relation to serum thyrotropin and thyroglobulin antibody status at time of diagnosis. Thyroid 2014;24:35-42.  Back to cited text no. 48
    
49.
Oltmann SC, Leverson G, Lin SH, Schneider DF, Chen H, Sippel RS. Markedly elevated thyroglobulin levels in the preoperative thyroidectomy patient correlates with metastatic burden. J Surg Res 2014;187:1-5.  Back to cited text no. 49
    
50.
Schlumberger M, Charbord P, Fragu P, Lumbroso J, Parmentier C, Tubiana M. Circulating thyroglobulin and thyroid hormones in patients with metastases of differentiated thyroid carcinoma: Relationship to serum thyrotropin levels. J Clin Endocrinol Metab 1980;51:513-9.  Back to cited text no. 50
    
51.
McDaniel RK, Luna MA, Stimson PG. Metastatic tumors in the jaws. Oral Surg Oral Med Oral Pathol 1971;31:380-6.  Back to cited text no. 51
    
52.
Al-Ani S. Metastatic tumors to the mouth: Report of two cases. J Oral Surg 1973;31:120-2.  Back to cited text no. 52
    
53.
Ripp GA, Wendth AJ Jr., Vitale P. Metastatic thyroid carcinoma of the mandible mimicking an arteriovenous malformation. J Oral Surg 1977;35:743-5.  Back to cited text no. 53
    
54.
Nishimura Y, Nakajima T, Yakata H, Kawasaki T, Fukushima M.. Metastatic thyroid carcinoma AQ8 of the mandible. J Oral Maxillofac Surg 1982;40:221-5.   Back to cited text no. 54
    
55.
Parichatikanond P, Parichatikanond P, Damrongvadha P, Kompairoj C, Chaovanapricha K. Jaw metastasis from follicular carcinoma of thyroid gland simulating ameloblastoma. J Med Assoc Thai 1984;67:362-7.  Back to cited text no. 55
    
56.
Kahn MA, McCord PT. Metastatic thyroid carcinoma of the mandible: Case report. J Oral Maxillofac Surg 1989;47:1314-6.  Back to cited text no. 56
    
57.
Hefer T, Manor R, Zvi Joachims H, Groisman GM, Peled M, Gov-Ari E, et al. Metastatic follicular thyroid carcinoma to the maxilla. J Laryngol Otol 1998;112:69-72.  Back to cited text no. 57
    
58.
Agarwal A, Mishra SK, Jain M. Follicular thyroid carcinoma with metastasis to the mandible. J Indian Med Assoc 1998;96:354-5.  Back to cited text no. 58
    
59.
Ostrosky A, Mareso EA, Klurfan FJ, Gonzalez MJ. Mandibular metastasis of follicular thyroid carcinoma. Case report. Med Oral 2003;8:224-7.  Back to cited text no. 59
    
60.
Kaveri H, Punnya VA, Tayyar AS. Metastatic thyroid carcinoma to the mandible. J Oral Maxillofac Path 2007;11:32-4.  Back to cited text no. 60
    
61.
Araki M, Nishimura S, Iwanari S, Sawada A, Matsumoto N, Honda K, et al. Mandibular metastases from follicular carcinoma of the thyroid gland: A case report. Oral Radiol 2008;24:85-9.  Back to cited text no. 61
    
62.
Kumar RV, Chakravarthy C, Sekhar GR, Devireddy SK, Kumaravelu C, Kare A. Metastatic thyroid carcinoma presenting as hypervascular lesion of the mandible: A case report and review of literature. J Oral Maxillofac Surg 2010;68:2613-6.  Back to cited text no. 62
    
63.
Yokoe H, Kasamatsu A, Ogoshi K, Ogawara K, Endo-Sakamoto Y, Ono K, et al. Mandibular metastasis from thyroid follicular carcinoma: A case report. Asian J Oral Maxillofac Surg 2010;22:208-11.  Back to cited text no. 63
    
64.
Bhadage CJ, Vaishampayan S, Umarji H. Mandibular metastasis in a patient with follicular carcinoma of thyroid. Contemp Clin Dent 2012;3:212-4.  Back to cited text no. 64
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65.
Naveena KA, Elamurugan T, Sreenath G, Jagdish S. Unusual oral cavity metastasis from follicular carcinoma of the thyroid – A case report. Internet J Head Neck Surg 2013;6:1-4.  Back to cited text no. 65
    
66.
Lavanya C, Ranganathan K, Veerabahu M. Mandibular metastasis of thyroid carcinoma: A case report. J Clin Diagn Res 2014;8:D15-6.  Back to cited text no. 66
    
67.
Hartinie M, Rosli YM, Muhd HA, Rusdi Abd R, Shaifulizan R. Metastatic thyroid follicular carcinoma to the mandible: A clinical note. Int Med J 2015; 22:327-9.  Back to cited text no. 67
    
68.
Loureiro AC, Figueiredo C, Matos JD, Lima RV, Vasconcelos RB, Nunes GA, et al. Metastasis of thyroid adenocarcinoma in mandible. Int J Dent Oral Sci 2017;4:439-43.  Back to cited text no. 68
    
69.
Varadarajan VV, Pace EK, Patel V, Sawhney R, Amdur RJ, Dziegielewski PT. Follicular thyroid carcinoma metastasis to the facial skeleton: A systematic review. BMC Cancer 2017;17:225.  Back to cited text no. 69
    
70.
Dave PK, Puranik M, Jain M, Mishra R, Jain Singhai M, Lakra R, et al. Unusual presentation of follicular thyroid carcinomaas mandibular metastasis. Surg Update Int J Surg Orthop 2018;4:68-70.  Back to cited text no. 70
    
71.
Jeon YT, Kim CH, Park SM, Kim MK. Distant metastasis of follicular thyroid carcinoma to the mandible: A rare case report. J Korean Assoc Oral Maxillofac Surg 2019;45:294-8.  Back to cited text no. 71
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7]
 
 
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    Abstract
   Introduction
   Case Report
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Journal of Oral and Maxillofacial Pathology | Published by Wolters Kluwer - Medknow
Online since 15th Aug, 2007