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Báo cáo y học: "Lung adenocarcinoma presenting as a solitary gingival metastasis: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Lung adenocarcinoma presenting as a solitary gingival metastasis: a case report. | Orlandi et al. Journal of Medical Case Reports 2011 5 202 http www.jmedicalcasereports.eom content 5 1 202 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Lung adenocarcinoma presenting as a solitary gingival metastasis a case report Armando Orlandi1 Michele Basso1 Mariantonietta Di Salvatore1 Francesco Federico2 Alessandra Cassano1 and Carlo Barone1 Abstract Introduction Gingival metastases are very rare and generally occur in disseminated tumors. We report a case of solitary gingival metastasis of lung cancer. Case presentation We report the case of a 74-year-old asymptomatic Caucasian woman affected by a rapidly growing painless gingival swelling. Histopathologic examination of the excisional biopsy showed metastasis of poorly differentiated thyroid transcription factor 1-positive adenocarcinoma. A total-body computed tomographic scan revealed a tumor of the right lung lower lobe with ipsilateral mediastinal lymph node swelling. Moreover bone scintigraphy revealed no bone metastases. No other metastases were found so we planned a multi-modal therapeutic approach with a curative intent. However the tumor proved to be intrinsically resistant and highly aggressive. Conclusion The presentation of solitary gingival metastasis is exceptional. In view of its rapid clinical evolution our case confirms that gingival metastasis is an important prognostic factor. This behavior raises the question whether the poor prognosis for patients with tumors with oral metastases depends on its diffuse spread or on its highly malignant nature. Introduction Oral metastatic tumors are rare comprising approximately 1 of all oral tumors 1 . The jawbones are affected in 90 of the cases whereas metastases to the soft tissues of the oral cavity occur very rarely and mostly involve the gingiva 54 of soft tissue metastases followed by the alveolar mucosa or the tongue 2 3 . Metastases may reach the oral cavity hematogen-ously mainly through inversion of the venous flow in the cervical