Clinical, Radiological and Histopathological Analysis of Metastatic Tumors of the Oral and Maxillofacial Region: A Retrospective Case Series.

Aim Oral metastatic tumors are rare and may present as vague pain or painless swellings and are misdiagnosed as odontogenic pathologic entities such as odontogenic cysts, tumors, pulpal or periapical diseases, etc. Since oral metastatic tumors are uncommon, the diagnosis of oral metastatic tumors is challenging for clinicians and pathologists. In this study, we aimed to analyze the clinical, histopathological, and radiological characteristics of oral metastatic tumors to assist clinicians and pathologists in achieving early diagnosis and proper management. Materials and methods The clinical, histopathological, and radiological characteristics of patients diagnosed with metastatic tumors of the oral cavity over the past 10 years at the Department of Oral Medicine and Radiology in Government Dental College, Thiruvananthapuram were retrospectively collected and analyzed. We analyzed complete medical and dental records of 1434 patients to assess the prevalence of oral metastatic tumors. A detailed analysis of clinical and radiological features of metastatic tumors was done by Oral Medicine and Radiology specialists. The primary tumor site and histopathological features were also evaluated.  Results Among 1434 cases, 10 (0.69%) cases of oral metastatic tumors with equal gender distribution (five male patients & five female patients) and a mean age of 54 years were obtained. In our retrospective study, the mandible was the most frequent site of metastases, and the most frequent complaint was painless swelling. Our findings demonstrated a consistent relationship between specific primary sites and gender, notably lung cancer in male patients and breast and thyroid cancer in female patients. Adenocarcinoma was the most frequent histological diagnosis, accounting for 50.0% (five out of ten cases) of the cases, and unilocular radiolucency was the most prevalent radiological presentation. Conclusion Our study showed that oral metastatic tumors frequently masquerade as benign conditions, most commonly presenting as painless swelling and unilocular radiolucencies. The high predilection for the posterior mandible (70%) and the significant association between specific primary sites and gender, notably lung cancer in male patients and breast/thyroid cancer in female patients, highlight the need for a high index of suspicion. Ultimately, as metastatic tumors of the oral cavity often mimic common dental pathologies, clinicians must prioritize thorough historical review and histological evaluation, particularly in older patients, to ensure early diagnosis and appropriate management of secondary malignancies.