Oral metastasis of a hepatocellular carcinoma

Pires, Fábio Ramôa; Sagarra, Regina Aparecida Martinho; Corrêa, Maria Elvira Pizzigatti; Pereira, Cláudio Maranhão; Vargas, Pablo Agustı́n; Lopes, Márcio Ajudarte

doi:10.1016/j.tripleo.2003.09.018

Cited by 60 publications

(33 citation statements)

References 38 publications

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“…To our knowledge, the true incidence of extrahepatic metastases to the jaws and oral region remains unknown. In addition, oral metastasis of hepatocellular carcinoma is uncommon with only 61 publishing cases reported in the literature (25). HCC in advanced stages is very devastating and can easily form metastases to other organs, including the oral region (25).…”

Section: Discussionmentioning

confidence: 99%

Metastatic carcinoma of the oral region: An analysis of 21 cases

Lee¹,

Lee²

2017

Med Oral

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Background: Metastatic carcinoma to the jaws and oral region are very rare, representing less than 1% of all oral tumors. Unfortunately, oral metastasis is usually manifestation of an advanced stage of primary cancer, and indicates widespread disease and poor prognosis. Material and Methods: In this retrospective study, a total of 2039 patients with history of oral malignant tumor between 1980 and 2012 at Seoul National University Dental Hospital were evaluated. We analyzed the dental and medical records, and histopathological database of 2039 patients to assess the prevalence of oral metastasis of carcinoma in terms of sex and age, as well as, the most common origin of primary cancer, and prevalent site and histopathological type of metastatic carcinoma. Results: Among 2039 patients, 21 (1.03%) were finally diagnosed with metastatic carcinoma of the jaws and oral region. Among the 21 patients, only 11 had a working diagnosis as oral metastasis upon clinical evaluation before performing a biopsy. The mean age at the time of diagnosis with a metastatic carcinoma was 56.86, and there was a male preponderance. Metastatic carcinoma was more frequent in the jaws than in the soft tissue, especially in the mandible compared to the maxilla. The most frequent primary site was the lungs, followed by the liver and breasts. The predominant histopathological types were hepatocellular carcinoma and adenocarcinoma. Patient outcomes indicated a poor prognosis with the time from the appearance of the metastasis to death was only 12 months. Conclusions: According to these cases, oral metastases of carcinoma were exceedingly rare in Koreans. It can allow the clinicians take into account the possible presence of metastases and lead to early diagnosis.

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Section: Discussionmentioning

confidence: 99%

Metastatic carcinoma of the oral region: An analysis of 21 cases

Lee¹,

Lee²

2017

Med Oral

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“…Among this series and other published cases in Korean or Japanese languages, more patients were from Asian areas including Japan, China, Korea, and Indonesia [3, 7–18, 25–29]. It seems that Asia should be the specific region with highest morbidity rate of HCC-metastatic gingival tumor, which is probably attributed to the geographic epidemiological characteristic of HCC [11, 12, 17].…”

Section: Discussionmentioning

confidence: 66%

“…Regional swelling, ulceration, and bleeding are much common like in our case and sometimes present as the earliest symptoms, to which enough attention should be paid [3, 11, 12, 17, 19]. Notably, gingival bleeding usually does not but perhaps relates to abnormal coagulation parameters due to defective liver functions, especially when the symptom is too severe to be controlled [12, 20].…”

Section: Discussionmentioning

confidence: 79%

“…In most instances, both the overall and truncated survival (from onset of oral metastatic tumor to death) in HCC patients with oral metastasis are very poor, with the average time being about 7 months and 21 weeks (range, 2 weeks to 2 years), respectively [3, 6, 12, 17]. Up to now, the survival of gingival metastasis by HCC is not very clear because of the rareness and scattering of such cases, which are always published without more detailed and systematic description.…”

Section: Discussionmentioning

confidence: 99%

“…Although embolization, radiotherapy, chemotherapy, and novel targeted therapy (sorafenib) have thrown much light, extensive cancer spreading including intrahepatic, abdominal, pulmonary, and cerebral metastases always significantly reduces the overall survival (OS) of patients with advanced HCC [2]. Some uncommon metastases such as those in oral cavity especially indicate a high malignant nature and poorer outcome of HCC [3]. Oral metastatic neoplasms are seldom seen and only reported in the minority of cancer patients, in which metastases to oral soft tissues remain rarer than to jawbones [4–6].…”

Section: Introductionmentioning

confidence: 99%

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Rare Gingival Metastasis by Hepatocellular Carcinoma

Xue

Mao

Geng

et al. 2017

Case Reports in Medicine

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Hepatocellular carcinoma (HCC) uncommonly metastasizes to the gingiva, which always means a poor outcome. We reported a rare HCC case with multiple metastases to gingiva, lungs, and brain. A 60-year-old man was initially diagnosed as HCC with metastases to double lungs. He was subjected to a transarterial chemoembolization (TACE) (5-fluorouracil, 750 mg) and two cycles of intravenous chemotherapy (gemcitabine 1.8 g at days 1 and 8, oxaliplatin 200 mg at day 2, every 4 weeks). However, the volume of liver tumor still increased. A bean-size gingival nodule growing with occasional bleeding was also found. TACE (5-fluorouracil 750 mg, perarubicin 40 mg, cisplatin 20 mg) was performed again and an oral sorafenib therapy (400 mg, twice per day) was adopted. The disease maintained relatively stable for about 6 months until a second obvious progress. The gingival nodule was then palliatively excised and identified as a poorly differentiated metastatic HCC by histopathological examination. Best supportive treatments were made since the performance score was too bad. Finally, cerebral metastases occurred and the patient died of systemic failure. Upon review of previous reports, we discussed risk factors, clinical and pathological characteristics, treatments, and prognosis of gingival metastasis by HCC.

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