Papillary Thyroid Carcinoma (PTC) primarily metastasizes via regional lymphatics making its spread to the oral cavity exceedingly rare. Although this disease remains the most common endocrine malignancy, comprising roughly 85%-90% of all thyroid cancers, its occurrence within the oral cavity happens in less than 1% of oral malignancies. This study identifies a case involving a 77-year-old male with a history of well-differentiated PTC that was initially treated with a total thyroidectomy and adjuvant radioactive iodine. Five years after his initial treatment, surveillance imaging demonstrated a 3 cm expansile mass of the left mandible. An incisional biopsy then confirmed the diagnosis of metastatic PTC. A segmental resection of his mandible was completed with final reconstruction utilizing a fibula free flap. Given the limited number of cases involving metastatic spread of PTC to the oral cavity, a standardized treatment algorithm does not exist. Thus, this case serves to provide a documented report of this rare occurrence and to review literature that may help other clinicians treat patients with this malignancy type. There remains a need for future studies to create risk stratification models for patients with metastatic PTC that consider margin analysis, genetic characteristics, and risk factors to tailor individual treatment plans.
Keywords: Case reports; Mandible; Metastasis; Thyroid cancer, Papillary.
Published by Elsevier Masson SAS.