Epulis-Like Presentation of Gingival Renal Cancer Metastasis

Abstract

Mouth metastatic cancers are very rare and they usually represent the evidence of a widespread disease. Common primary tumors are lung carcinoma in men and breast carcinoma in women, followed by kidney cancer. In the oral soft tissues, the gingiva is the most common site, suggesting a possible role of inflammation in the attraction of circulating tumor cells. Oral metastasis has a serious prognosis. In this work, we describe the case of a 58-year-old man affected by renal cancer, who was brought to our attention for the appearance of a gingival swelling. Initially, the lesion was excised through a provisional clinical diagnosis of epulis. Subsequently, anatomopathological analysis showed a metastasis compatible with clear-cell carcinoma and specifically its renal origin was confirmed by immunohistochemical techniques.

Multiple gingival metastasis of renal cell carcinoma: a case report

“…Approximately 25% of patients with RCC already have metastatic disease at the time of diagnosis and initial assessment. After lung and breast cancer, RCCs represent the third primary localization of subclavicular cancers resulting in metastases in the oral cavity [2,7]. The presentation of tumor observed in our case corresponds to the description in the literature.…”

“…Metastases are generally polypoid or exophytic, may or may not be ulcerated, are richly vascularized, and often result in bleeding. Differential diagnosis with pyogenic granuloma, giant cell granuloma, hemangioma, or fibrous epulis may be difficult and lead to delayed diagnosis if primary tumor is unknown [7,8]. However, metastasis should be systematically suspected when the primary cancer is already known, especially since it is already metastatic, as is the case for our patient [9].…”

“…The prognosis of a patient with oral metastases is poor, with an average survival rate of 7 months [7]. The choice of treatment depends on the disease stage and patient-related factors.…”

Granulomatous Lesion in Inserted Gum-Metastasis of Renal Clear Cell Carcinoma. Case Presentation

“…Así mismo el carcinoma de células renales es la tercera neoplasia más frecuente en metastatizar en la región de la cabeza y cuello, precedida del carcinoma de mama y pulmón (7,16,(24)(25)(26)(27)(28)(29).…”

“…En la región de cabeza y cuello las metástasis de carcinoma de células renales se localizan con mayor frecuencia en cavidad nasal y senos paranasales, seguidos de la cavidad oral, siendo la encía adherida y lengua los sitios más comunes a pesar de ser infrecuentes (24,25,29,30). Además, el pronóstico de los pacientes con metástasis en cavidad oral es pobre y el tratamiento habitualmente es paliativo para mejorar la calidad de vida y prevenir complicaciones (16).…”