Gingival Metastasis from Rectal Cancer

Abstract

We report a 51-year-old woman who had undergone surgical resection of Dukes'B rectal cancer. On postoperative day 30, she noticed a dark red swelling in the right upper gingival, for which immunohistochemical study of the biopsy specimen revealed metastasis from the rectal cancer.

The “Epulis” Dilemma. Considerations from Provisional to Final Diagnosis. A Systematic Review

“…Fukuda et al [38] suggested that the criteria for considering an oral malignant neoplasm as metastatic are: a primary tumor with histologic verification, a second oral lesion histologically relevant to the primary tumor, a histopathologic appearance of the oral lesion distinct from that of a typical oral malignancy and exclusion of a possible direct extension from the primary tumor. Kawamura et al [23], Moser et al [26], Wu et al [33], Shah et al [28] and Chiarelli et al [21] reported the occurrence of gingival metastasis. Kawamura et al [23] treated a patient who previously underwent a surgical procedure for poorly differentiated rectal carcinoma.…”

“…Localized chronic gingival enlargements are frequently detected by clinicians and the management requires a rational approach. These neoformations occur with the following characteristics [1][2][3][20][21][22][23][24][25][26][27][28][29][30][31][32][33]35,36 A careful collection of data regarding the medical history of the patient must always be the first step to take in the process that will lead the clinician to the final diagnosis. Sometimes the medical history might be not relevant at all, whereas at other times it might be of great help.…”

“…The choice between an excisional or incisional biopsy might be challenging. Incisional biopsy instead of complete excision of the lesion should be taken into consideration when one or more of the following features are present [17,23,25,26,28,30 A detailed investigation through a histopathological examination is mandatory for the final diagnosis. Immunohistochemical evaluation is also of great help, especially in the most challenging scenarios.…”

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“…This was due to the first surgery being performed at a different hospital and hence us being unable to trace the slides for a comparison. The route of spread of bowel cancer is mainly haematogenous [5,8]. The spread to oral cavity can either be directly from the primary tumour or can originate from another previous site of metastasis.…”

Oral metastasis from rectal adenocarcinoma: case report

“…Therefore, misdiagnosis of oral lesions by family dentist has been reported [10] . In our case, the tumor rather mimicked an oral ulceration or squamous cell carcinoma.…”