MKI67 and metastasis: The prognostic factors of this disease include age, Hyams histopathological grading, cervical lymph node metastasis, treatment, and proliferation index.[22,23] Ki-67 > 10% usually suggests a poor prognosis.[24] In our patient, bone and bone marrow metastasis, Hyams Histopathology classification IV, Ki-67 over 85% and increased serum lactate dehydrogenase suggested a poor prognosis.