1
|
Li B, Lin Y, Yang Y, Wang Z, Shi R, Zheng T, Liao B, Liao G, Huang J. Patients with periodontitis might increase the risk of urologic cancers: a bidirectional two-sample Mendelian randomization study. Int Urol Nephrol 2024; 56:1243-1251. [PMID: 38015384 PMCID: PMC10923993 DOI: 10.1007/s11255-023-03858-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/14/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Numerous observational epidemiological studies have reported a bidirectional relationship between periodontitis and urological cancers. However, the causal link between these two phenotypes remains uncertain. This study aimed to examine the bidirectional causal association between periodontitis and four types of urological tumors, specifically kidney cancer (KC), prostate cancer (PC), bladder cancer (BC), and testis cancer (TC). METHODS Based on large-scale genome-wide association study (GWAS) data, we utilized the two-sample Mendelian randomization (MR) approach to evaluate causal relationships between periodontitis and urological cancers. Several MR methods covering various consistency assumptions were applied in this study, including contamination mixture and Robust Adjusted Profile Score to obtain robust results. Summary-level data of individuals with European ancestry were extracted from the UK Biobank, the Kaiser GERA cohorts, and the FinnGen consortium. RESULTS Our findings revealed significant positive genetic correlations between periodontitis and kidney cancer (OR 1.287; 95% CI 1.04, 1.594; P = 0.020). We did not find a significant association of periodontitis on prostate cancer, bladder cancer, and testis cancer. In reverse MR, no significant results were observed supporting the effect of urologic cancers on periodontitis (all P > 0.05). CONCLUSION Our study provides the evidence of a potential causal relationship between periodontitis and kidney cancer. However, large-scale studies are warranted to confirm and elucidate the underlying mechanisms of this association.
Collapse
Affiliation(s)
- Bojia Li
- Health Management Center, General Practice Medical Center, Medical Device Regulatory Research and Evaluation Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
- West China School of Public Health, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Yifei Lin
- Health Management Center, General Practice Medical Center, Medical Device Regulatory Research and Evaluation Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Yong Yang
- Health Management Center, General Practice Medical Center, Medical Device Regulatory Research and Evaluation Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Zeng Wang
- Engineering Research Center of Medical Information Technology, Ministry of Education, West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Rui Shi
- Engineering Research Center of Medical Information Technology, Ministry of Education, West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Tao Zheng
- Engineering Research Center of Medical Information Technology, Ministry of Education, West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Banghua Liao
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, 610044, People's Republic of China.
| | - Ga Liao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China.
| | - Jin Huang
- Health Management Center, General Practice Medical Center, Medical Device Regulatory Research and Evaluation Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
| |
Collapse
|
2
|
Mohammed MH, Mardnly F, Ghrer M, Alia L, Assad LW. Unusual metastasis after radical cystectomy: case report. J Surg Case Rep 2024; 2024:rjae112. [PMID: 38455984 PMCID: PMC10918444 DOI: 10.1093/jscr/rjae112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/11/2024] [Indexed: 03/09/2024] Open
Abstract
Cutaneous metastasis of urothelial carcinoma after radical cystectomy is extremely rare. We present the case of a 57-year-old man who underwent a radical cystectomy with ileal conduit for the presence of a bladder tumor. He developed a cheek lesion after 2 months, which was diagnosed as a metastatic nodule along with bone metastases from high-grade bladder urothelial carcinoma. This nodule was treated with surgical removal with subsequent chemotherapy, but he succumbed after 10 months due to widespread metastatic disease.
Collapse
Affiliation(s)
- Mohammed H Mohammed
- Urology, Damascus University, Al Assad University Hospital, Damascus 30621, Syria
| | - Fadel Mardnly
- Urology, Damascus University, Al Assad University Hospital, Damascus 30621, Syria
| | - Mohamad Ghrer
- Urology, Damascus University, Al Assad University Hospital, Damascus 30621, Syria
| | - Louei Alia
- Urology, Damascus University, Al Assad University Hospital, Damascus 30621, Syria
| | | |
Collapse
|
3
|
Kim HJ, Sim JY, Kim MB, Chang SW. Unusual Cervical Lymph Node Metastasis of Papillary Urothelial Carcinoma. EAR, NOSE & THROAT JOURNAL 2024; 103:NP4-NP6. [PMID: 34325542 DOI: 10.1177/01455613211036222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Papillary urothelial carcinoma is aggressive and characterized by frequent metastasis to distant sites at an early stage. Papillary urothelial carcinoma of the urinary bladder usually metastasizes to the local lymph nodes, liver, lungs, bone, and mediastinum. Urogenital tract carcinoma of the head and neck metastasis is uncommon and rarely reported to the cervical lymph nodes. We present a case of cervical lymph node metastasis of papillary urothelial carcinoma of the urinary bladder.
Collapse
Affiliation(s)
- Hyun Jung Kim
- Department of Otorhinolaryngology, Jeju National University School of Medicine, Jeju, Republic of Korea
| | - Jae-Yeop Sim
- Department of Otorhinolaryngology, Jeju National University School of Medicine, Jeju, Republic of Korea
| | - Min Bum Kim
- Department of Otorhinolaryngology, Jeju National University School of Medicine, Jeju, Republic of Korea
| | - Suk Won Chang
- Department of Otorhinolaryngology, Jeju National University School of Medicine, Jeju, Republic of Korea
| |
Collapse
|
4
|
Frydenlund N, Zakharia Y, Garje R, Dahmoush L, O'Donnell MA. Non-Muscle Invasive Papillary Urothelial Carcinoma Metastatic to the Mandible. J Investig Med High Impact Case Rep 2018; 6:2324709618806332. [PMID: 30349834 PMCID: PMC6194919 DOI: 10.1177/2324709618806332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 08/22/2018] [Accepted: 08/30/2018] [Indexed: 11/28/2022] Open
Abstract
Urothelial carcinoma, the most common histologic subtype of bladder cancer in the United States, most frequently presents as non–muscle invasive disease. Initially, therapy involves transurethral endoscopic resection and subsequent intravesical therapies with extended surveillance for high-risk disease. Even with the best treatments, recurrence and progression can occur. However, metastasis of non–muscle invasive bladder cancer to distant sites without evidence of progression or regional metastasis is rare. In this article, we present the case of a patient with high-grade papillary urothelial carcinoma who developed an unusual metastasis to the mandible, confirmed by GATA-3 immunostaining, over 4 years after initial transurethral resection. Prior to the development of metastatic disease, this patient had no evidence of local recurrence during maintenance Bacillus Calmette-Guerin intravesical therapy and concurrent surveillance. Positron emission tomography-computed tomography taken after presentation with mandibular metastasis did not show any evidence of regional metastasis. This case highlights an unusual location for distant metastasis of urothelial carcinoma occurring in a patient without evidence of muscle invasive disease or regional metastasis. We additionally highlight the utility of GATA-3 immunostaining in identifying urothelial carcinoma histologically.
Collapse
Affiliation(s)
| | - Yousef Zakharia
- University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Rohan Garje
- University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Laila Dahmoush
- University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | | |
Collapse
|
5
|
Irani S. Metastasis to the Jawbones: A review of 453 cases. J Int Soc Prev Community Dent 2017; 7:71-81. [PMID: 28462174 PMCID: PMC5390582 DOI: 10.4103/jispcd.jispcd_512_16] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 03/05/2017] [Indexed: 12/16/2022] Open
Abstract
The purpose of the present article was to review the characteristics of the jawbone metastases to analyze all variables. A relevant English Literature search in PubMed, Scopus, and Google Scholar was performed. All variables such as age, gender, primary and secondary tumor sites were analyzed. There were 453 metastatic cases. The male-to-female ratio was 1.2:1, and the mean age of the patients was 53.4 years. The lung was the most common primary site in men, and breast in women. The most common metastatic site was the mandible, and adenocarcinoma was the most frequent histological diagnosis. Metastases to the jaw bones occur in the advanced stages of a malignancy hence; a careful examination of patients with jaw bone lesions is strongly suggested. Dentists, as well as general physicians, should take into consideration the possible presence of jaw metastases in cases which present atypical symptoms, especially in patients with known malignant disease.
Collapse
Affiliation(s)
- Soussan Irani
- Department of Oral Pathology, Dental Research Centre, Dental Faculty, Hamadan University of Medical Sciences, Hamadan, Iran
| |
Collapse
|
6
|
Irani S. Metastasis to the oral soft tissues: A review of 412 cases. J Int Soc Prev Community Dent 2016; 6:393-401. [PMID: 27891304 PMCID: PMC5109852 DOI: 10.4103/2231-0762.192935] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 07/22/2016] [Indexed: 12/17/2022] Open
Abstract
The present review article analyzes the characteristics of metastases to the oral soft tissues from 1937 to 2015. An extensive literature search was performed. All variables such as age, gender, and primary and secondary tumor sites were analyzed. Metastases to the major salivary glands were not included in this review. In general, there were 412 metastatic lesions developed in the oral soft tissues. The male-to-female ratio was approximately 1.8:1. The mean age of the patients at diagnosis was 58. The lung was the most common primary site and the gingiva was the most common metastatic site. The greater part of the histological examination yielded adenocarcinoma. The diagnosis of a metastatic lesion in the oral cavity is a challenge to the clinicians due to the lack of pathognomonic signs and symptoms. Oral metastases usually occur in the advanced stages of cancers, and the interval between appearance and death is usually short. The oral soft tissue metastasis can be easily recognized compared to the metastasis of jawbones. Early detection of oral lesions is important in the case of being the first sign of a malignancy in other parts of body.
Collapse
Affiliation(s)
- Soussan Irani
- Dental Research Center, Department of Oral Pathology, Dental Faculty, Hamadan University of Medical Sciences, Hamadan, Iran
| |
Collapse
|
7
|
Khurram SA, Farthing PM, Whitworth A, McKechnie AJ, Fernando M. High-grade urothelial carcinoma with squamous differentiation metastasizing to the tongue. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 121:e111-5. [PMID: 26525101 DOI: 10.1016/j.oooo.2015.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 08/11/2015] [Accepted: 08/21/2015] [Indexed: 11/29/2022]
Abstract
Tumors metastasizing to the head and neck region are uncommon. Metastasis of urothelial carcinoma to the maxillofacial region is exceedingly rare and mostly involves the jaw. We present a case of urothelial carcinoma metastasizing to the tongue. Immunohistochemistry in conjunction with fluorescent in situ hybridization was used to confirm the relation between the primary and metastatic lesions, making it the first such reported case employing the UroVysion (Catalogue number 02 J27-025, Abbott Molecular Inc., Des Plaines, IL, USA) fluorescent in situ hybridization probe in a metastatic lesion in the head and neck region.
Collapse
Affiliation(s)
- Syed A Khurram
- Unit of Oral and Maxillofacial Pathology, School of Clinical Dentistry, 19 Claremont Crescent, Sheffield, UK.
| | - Paula M Farthing
- Unit of Oral and Maxillofacial Pathology, School of Clinical Dentistry, 19 Claremont Crescent, Sheffield, UK
| | - Abigail Whitworth
- Sheffield Diagnostic Genetics Service, Sheffield Children's Hospital NHS Foundation Trust, Western Bank, Sheffield, UK
| | - Alasdair J McKechnie
- Department of Oral and Maxillofacial Surgery, Charles Clifford Dental Hospital, Wellesley Road, Sheffield, UK
| | - Malee Fernando
- Department of Histopathology, Royal Hallamshire Hospital, Glossop Road, Sheffield, UK
| |
Collapse
|
8
|
Öztürk H. Evaluation of the response chemotherapy for penile metastasis of bladder cancer using 18F-fluorodeoxyglucose-PET/CT. Int J Surg Case Rep 2015; 11:33-36. [PMID: 25912005 PMCID: PMC4446685 DOI: 10.1016/j.ijscr.2015.04.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 04/07/2015] [Accepted: 04/07/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Metachronous penile metastasis of bladder cancer occurs very rarely. The clinical management of the disease involves complex problems, and the disease is associated with a poor prognosis. The common mode of spread to the penis is by the retrograde venous route. PATIENTS AND METHODS A 68-year-old patient who was diagnosed with invasive bladder cancer underwent (18)F-fluorodeoxyglucose (FDG)-positron-emission tomography/computed tomography (PET/CT) for staging purposes. An 18mm intracavernosal metastatic lesion was detected in the penis with a SUVmax of 12.9. RESULTS After the administration of gemcitabine+cisplatin-based chemotherapy, remission was observed in the metastatic penile lesion according to EORTC criteria (12mm, SUVmax: 9), and second line chemotherapy program was planned. CONCLUSION Penile metastasis from bladder cancer is an indicator of poor prognosis. The patients with penile metastasis poorly respond to therapy, despite the use of effective systemic chemotherapy. The researchers of the current study achieved a partial response to chemotherapy in the current case of penile metastasis. The disease-specific life expectancy is less than one year in these patients. Radical ablative surgery does not contribute to survival; however, it offers an alternative method in symptomatic patients.
Collapse
Affiliation(s)
- Hakan Öztürk
- Department of Urology, School of Medicine, Sifa University, Izmir, Turkey.
| |
Collapse
|
9
|
Cheek metastasis from a bladder tumor: unusual presentation of an aggressive disease. Urologia 2013; 80:317-21. [PMID: 23813285 DOI: 10.5301/urologia.5000022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2013] [Indexed: 11/20/2022]
Abstract
Transitional cell carcinoma (TCC) has been well described for its propensity to metastasize to distant sites. Metastases to the soft tissues of the oral cavity from a bladder cancer are extremely rare. We present the case of a 65-year-old man who presented with history of hematuria for 1 month and was found to have high-grade TCC of the bladder. He developed a cheek lesion after 3 weeks, which was diagnosed as metastatic nodule along with pulmonary metastases from high-grade bladder TCC. The patient received chemotherapy followed by the radiotherapy of the cheek lesion, but he succumbed after 3 months due widespread metastatic disease. We also presented a review of the literature regarding this rare presentation.
Collapse
|
10
|
Lee KS, Song IC, Yun HJ, Jo DY, Kim S, Lee HJ. Transitional cell carcinoma of the urinary bladder metastatic to the oral mucosa. Oncol Lett 2012; 3:343-345. [PMID: 22740909 DOI: 10.3892/ol.2011.476] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Accepted: 11/02/2011] [Indexed: 11/06/2022] Open
Abstract
Metastatic tumors in the oral cavity are rare and usually affect the jaws more often than the oral soft tissues. In particular, metastases confined to the oral mucosa are extremely rare and originate mainly from the lung and breast. Only one case restricted to the oral mucosa and originating from urinary bladder carcinoma has previously been described. We report on a painful polypoid mass located in the oral mucosa with no bone involvement that was confirmed to be a metastatic oral tumor that originated from transitional cell carcinoma of the urinary bladder and progressed rapidly.
Collapse
Affiliation(s)
- Kyu Seob Lee
- Division of Hematology/Oncology, Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | | | | | | | | | | |
Collapse
|
11
|
Tatlidil R, Gözübüyük MM. Mucinous adenocarcinoma of lung presenting as oral metastases: a case report and literature review. J Endod 2011; 37:110-3. [PMID: 21146088 DOI: 10.1016/j.joen.2010.09.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2009] [Revised: 09/16/2010] [Accepted: 09/19/2010] [Indexed: 11/30/2022]
Abstract
BACKGROUND Metastasis of a malignant tumor to the oral cavity is rare and can indicate an unknown primary tumor. METHODS Described is a case of metastatic tumor in the right jaw. The patient was a 50-year-old woman who consulted her dentist with complaints of tooth pain and an abscess. The clinical examination showed an abscess around the mandibular right first molar and second premolar tooth. Teeth were extracted and two periapical, nontypical cystic lesions were excised. RESULTS The histopathological analysis revealed mucinous malignant cells embedded in an inflammatory infiltration and fibrinous tissue. The diagnosis was metastatic mucinous adenocarcinoma. The lesion at the apex of teeth was the initial presenting site of the patient's lung cancer. There was no other site of metastasis. CONCLUSIONS There are typical dental apical cysts that do not usually require a histopathological examination, but mucinous and nontypical cysts must be sent for a histopathological examination. The case emphasizes the important role of dentists in diagnosing metastatic oral lesions and shows that even apparently benign atypical lesions in healthy patients need to be examined histopathogically.
Collapse
|
12
|
Chan CHF, Al-Busafi SA, Waschke KA. Massive upper gastrointestinal bleeding secondary to duodenal metastasis of transitional cell carcinoma of the urinary bladder. Case Rep Gastroenterol 2011; 5:246-8. [PMID: 21577372 PMCID: PMC3094684 DOI: 10.1159/000327978] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Acute upper gastrointestinal (UGI) bleeding is a common problem in our clinical practice and is often due to peptic ulcer diseases. Occasionally, malignancy may be implicated in these situations. Here we report a rare case of UGI bleeding secondary to metastatic transitional cell carcinoma (TCC) of the urinary bladder. A 62-year-old man with a history of stage IIIb TCC of the urinary bladder presented with hematemesis. Endoscopy showed a large tumor in the second stage of the duodenum that occupied 40% of the duodenal circumference, over 7 cm in length. Biopsies revealed a poorly differentiated malignant neoplasm consistent with metastasis from urothelial carcinoma that was identical to the previous surgical specimen of the urinary bladder. He was treated with supportive therapy and intravenous proton pump inhibitor and was discharged home 2 weeks later. Two weeks after discharge, the patient returned to the hospital with a painful swelling of the floor of his mouth. Biopsy again showed the same cancer type. He had unremitting bleeding from his mouth requiring multiple transfusions and a course of palliative radiation therapy. He progressively deteriorated in his cardiopulmonary and neurological functions and expired with cardiopulmonary arrest one month later.
Collapse
Affiliation(s)
- Carlos H F Chan
- Division of General Surgery, Department of Surgery, McGill University Health Centre, Montreal, Que., Canada
| | | | | |
Collapse
|
13
|
Shen ML, Kang J, Wen YL, Ying WM, Yi J, Hua CG, Tang XF, Wen YM. Metastatic tumors to the oral and maxillofacial region: a retrospective study of 19 cases in West China and review of the Chinese and English literature. J Oral Maxillofac Surg 2009; 67:718-37. [PMID: 19304027 DOI: 10.1016/j.joms.2008.06.032] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2007] [Revised: 02/28/2008] [Accepted: 06/16/2008] [Indexed: 01/12/2023]
Abstract
PURPOSE The aim of this article was to obtain an overview of metastatic tumors to the oral and maxillofacial (OMF) region, especially the differences in the constituent ratios of primary cancers between the United States and China. PATIENTS AND METHODS Clinical findings of 19 cases encountered in West China Hospital of Stomatology were summarized and the English and Chinese literature were reviewed and analyzed. The main clinical features of OMF metastases were summarized, with an emphasis on primary cancers' constituents. RESULTS The lung, breast, kidney, liver, and prostate were the top 5 common primary sites of cancer. However, there was a significant difference in the primary cancers' constituents between United States and China (P < .001). The breast, kidney, prostate cancers, and melanoma of skin were more frequent primary cancers in United States than in China, whereas that of the lung, thyroid, liver, esophagus, and the stomach were more common in China than in United States. The proportions of the OMF metastatic lesions originating in the lung, kidney, liver, thyroid, and esophagus in all OMF metastatic tumors were higher than the corresponding primary cancers' prevalent proportions. CONCLUSIONS The frequency of developing OMF metastasis is not always consistent with primary cancers' prevalence, which suggests that different cancers have different potentiality to develop OMF metastasis. Cancers of the kidney, liver, lung, thyroid, and esophagus were more likely to spread to the OMF region. In general screening of primary cancer, it would be helpful to take into account the metastatic potentiality of different cancers and primary cancers' prevalence in different countries in the case of occult primary.
Collapse
Affiliation(s)
- Mo-Lun Shen
- Master of Medicine, Department of Head and Neck Oncology, West China College of Stomatology, Sichuan University, Chengdu, China
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Ureteral cancer first recognized by mechanical ileus due to intestinal metastasis. Jpn J Radiol 2009; 27:48-52. [PMID: 19373533 DOI: 10.1007/s11604-008-0294-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2008] [Accepted: 10/20/2008] [Indexed: 10/20/2022]
Abstract
We report a case of ureteral transitional cell carcinoma (TCC) first recognized because of mechanical ileus due to intestinal metastasis without definitive evidence of hydronephrosis or ureteral mass on plain computed tomography. We believe this to be the first case of ureteral TCC that was first recognized because of mechanical ileus due to small intestinal metastasis.
Collapse
|
15
|
|
16
|
Bernabé DG, Veronese LA, Miyahara GI, Conrado-Neto S, Biasoli ÉR. Gingival Metastasis From Salivary Duct Carcinoma of the Parotid Gland. J Periodontol 2008; 79:748-52. [DOI: 10.1902/jop.2008.070283] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
17
|
Hirshberg A, Shnaiderman-Shapiro A, Kaplan I, Berger R. Metastatic tumours to the oral cavity - pathogenesis and analysis of 673 cases. Oral Oncol 2007; 44:743-52. [PMID: 18061527 DOI: 10.1016/j.oraloncology.2007.09.012] [Citation(s) in RCA: 295] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2007] [Revised: 09/19/2007] [Accepted: 09/19/2007] [Indexed: 02/07/2023]
Abstract
The oral region is an uncommon site for metastatic tumour cell colonization and is usually evidence of a wide spread disease. In 25% of cases, oral metastases were found to be the first sign of the metastatic spread and in 23% it was the first indication of an undiscovered malignancy at a distant site. The jawbones, particularly the mandible, were more frequently affected than the oral soft tissues (2:1). In the oral soft tissues, the attached gingiva was the most commonly affected site (54%). The major primary sites presenting oral metastases were the lung, kidney, liver, and prostate for men, breast, female genital organs (FGO), kidney, and colo-rectum for women. The primary site differs according to oral site colonization, in men the lung was the most common primary site affecting both the jawbones and oral mucosa (22% and 31.3%, respectively) followed by the prostate gland in the jawbones (11%) and kidney in the oral soft tissues (14%). In women, the breast was the most common primary tumour affecting the jawbones and soft tissues (41% and 24.3%, respectively), followed by the adrenal and female genital organs (FGO) in the jawbones (7.7%) and FGO in the soft tissues (14.8%). The clinical presentation of the metastatic lesions differ between the various sites in the oral region. In the jawbones most patients complain of swelling, pain and paresthesia which developed in a relative short period. Early manifestation of the gingival metastases resembled a hyperplastic or reactive lesion, such as pyogenic granuloma, peripheral giant cell granuloma, or fibrous epulis. Because of its rarity, the diagnosis of a metastatic lesion in the oral region is challenging, both to the clinician and to the pathologist, in recognizing that a lesion is metastatic and in determining the site of origin. The clinical presentation of a metastatic lesion in the oral cavity can be deceiving leading to a misdiagnosis of a benign process, therefore, in any case where the clinical presentation is unusual especially in patients with a known malignant disease a biopsy is mandatory.
Collapse
Affiliation(s)
- Abraham Hirshberg
- Department of Oral Pathology and Oral Medicine, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
| | | | | | | |
Collapse
|
18
|
Poulopoulos A, Vahtsevanos K, Kiziridou A. Metastatic carcinoma of the urinary bladder presenting as a submental swelling. ACTA ACUST UNITED AC 2005. [DOI: 10.1016/j.ooe.2005.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
19
|
Siriwardena B, Tilakaratne W, Rajapaksa R. Metastatic transitional cell carcinoma of the urinary bladder to the mandible. ACTA ACUST UNITED AC 2005. [DOI: 10.1016/j.ooe.2004.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
20
|
Elkhoury J, Cacchillo DA, Tatakis DN, Kalmar JR, Allen CM, Sedghizadeh PP. Undifferentiated Malignant Neoplasm Involving the Interdental Gingiva: A Case Report. J Periodontol 2004; 75:1295-9. [PMID: 15515348 DOI: 10.1902/jop.2004.75.9.1295] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Metastases to the gingiva are uncommon. They can be a diagnostic challenge clinically because of their rarity and tendency to mimic benign lesions. In this report, we present a case of an undifferentiated malignant neoplasm of unknown origin presenting as benign inflammatory gingival lesions and we review the literature on metastases to the gingiva. METHODS A 44-year-old female patient was referred by a local periodontist for evaluation of multiple painless gingival lesions that clinically resembled pyogenic granulomas or periodontal abscesses, but with an uncharacteristic multifocal presentation in the background of good oral hygiene. Her medical history was unremarkable except for recent weight loss. Periapical radiographs were obtained, as well as two incisional biopsies, one placed in formalin for routine histology and immunohistochemistry, the other in phosphate buffered saline for flow cytometry. RESULTS Radiographic findings were non-contributory for hard tissue pathoses. Histopathological findings were consistent with a poorly differentiated malignancy, suggestive of metastatic disease. Immunohistochemical studies and flow cytometry were unsupportive in delineating any tumor differentiation. The patient subsequently developed multiple tumors throughout the body with similar histopathological findings, yet no primary tumor was identified and a definitive diagnosis could not be rendered. She was discharged one month later in poor condition with the principal diagnosis of hemorrhage/ pancytopenia, and a secondary diagnosis of metastatic head and neck cancer. CONCLUSION This case of malignant metastatic tumor of unknown origin presenting as benign gingival lesions illustrates the importance of thorough patient evaluation, which should include a biopsy when necessary for definitive diagnosis.
Collapse
Affiliation(s)
- Jad Elkhoury
- Section of Periodontology, The Ohio State University, College of Dentistry, Columbus, OH 43218-2357, USA
| | | | | | | | | | | |
Collapse
|
21
|
|