Pathways of spread:

• Direct extension
• Lymphatic/ vascular dissemination
• Intraspinal seeding (through Batson plexus of veins)

Most frequent sites: Vertebrae, ribs, pelvis, skull

Common sources of jaw metastases: Breast, prostate, lungs, colorectal & kidneys

Clinical:

• Elderly patient
• Pain
• Swelling
• Loosening of teeth
• A mass
• Paraesthesia
• Hx primary tumour

Histology: Poorly differentiated malignant cells with little resemblance to the tissue of origin,
confirmation usually done with immunohistochemistry

Management: Low survival rates because metastases usually implies that patient is in Stage IV. Most patients do not survive more than 1 yr

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