1
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Lingual metastasis as the first presentation of clear cell renal cell carcinoma: Report of a rare case clinically mimicking a benign lesion. Oral Oncol 2023; 137:106293. [PMID: 36565486 DOI: 10.1016/j.oraloncology.2022.106293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022]
Abstract
Metastases in the oral cavity are rare and frequently associated with widespread disease and poor prognosis. Clear cell renal cell carcinoma (ccRCC) is the most common subtype of renal cell carcinoma (RCC), known for its propensity for metastatic spread. The diagnosis of oral metastases from ccRCC is challenging, especially when the patient has no history of primary neoplasm. Herein, we reported a rare metastatic ccRCC in a 58-year-old female presenting clinically as a painless nodule on the tongue mimicking a benign lesion. Microscopically, the tumor showed a proliferation of clear cells organized in nests with a predominantly lobular arrangement. The dense connective tissue stroma was highly vascularized, exhibiting some areas with a hyalinized aspect. Immunohistochemistry showed focal positivity for pan-cytokeratin AE1/AE3 and strong positivity for CK8, CK18, epithelial membrane antigen (EMA), vimentin, and CD10. S-100 protein, HMB-45, CK7, and CK20 were negative. The definitive diagnosis was metastatic ccRCC. The treatment was initiated with sunitinib. However, the disease progressed, and the patient was submitted to palliative care. Despite the low survival rate of patients with metastases, the clinician's experience in identifying an oral metastatic lesion may reveal undiagnosed primary tumors and provide better prognosis and survival rates.
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2
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Labrador AJP, Marin NRG, Valdez LHM, Sanchez KBT, Zabarburu W, Ibazetta KAR, Garcia AER, Cabezas DM, Romero L, Conte AM, Wright JM. Metastasis to the oral and maxillofacial region. A systematic review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e474-e483. [PMID: 34933137 DOI: 10.1016/j.jormas.2021.12.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/06/2021] [Accepted: 12/15/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Metastasis to oral and maxillofacial region (MOMFR) is an unusual finding; representing between 1 and 1.5% of all malignancies in the maxillofacial region. A systematic review is presented to determine trends in presentation, diagnostic features, and patient outcome. METHODS Searches of databases were carried out for papers reporting MOMFR. The variables were demographics, patient symptoms, tumor location, tumor size, histopathology, origin of the tumor, immunohistochemical studies, follow-up and survival. RESULTS 696 cases were identified; 391 males, and 305 females. The most common race was white. The most common primary tumor for females was from breast 31.1% (n = 95), for males from lung 20.5% (n = 143). The most common location was the mandible 44.9% (n = 313), followed by gingival soft tissue 16.8% (n = 117). A frequent clinical symptom was pain with 17.5% (n = 122). The most common clinical presentation was a mass or tumor 37.4% (n = 260). The mean age was 58.8 years. The average time before diagnosis was 10.3 months, the mean follow-up after diagnosis was 13.1 months, and the average survival was 9.8 months. CONCLUSION MOMFR shows a strong predilection for the posterior mandible, with a mass or tumor being the most common clinical presentation. They are frequently painful, and demonstrate a poor prognosis.
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Affiliation(s)
- Alberto Jose Peraza Labrador
- Oral surgeon and oral pathologist director centro de odontologia integral acarigua, Mailing address: av 5 de diciembre cc metropolitan local 6, Venezuela.
| | | | - Luciano Hermios Matos Valdez
- Oral Patohology director. Diagnocentrobucal, Mailing address: Las Golondrinas Mz. B lote 9, Los Olivos, Lima, Peru
| | - Katman Bear Toledo Sanchez
- Resident oral pathology program cayetano Heredia peru. Oral and maxilofacial pathology and medicine clinics, Mailing address: Av. El Olivar, 3879 San Martin de Porres, Lima, Peru
| | - Wil Zabarburu
- Director of Dental healthcare clinic, Av principal Lote 7. Micaela Bastidas 2, Lima, Peru
| | - Karem Annelise Rodriguez Ibazetta
- Associated of Oral and maxilofacial pathology and medicine clinics department. Mailing address: Av. Pablo Carriquiry 705, San Isidro, Lima, Peru
| | - Alejandra Elvia Ruiz Garcia
- Director Oral and maxilofacial pathology and medicine clinics. Mailing address: Cooperativa Santa Polonia Mz. N lote 15, San Martin de Porres, Lima, Peru
| | - Dayana Mamani Cabezas
- Director associated. Oral and maxilofacial pathology and medicine clinics. Mailing address: Av. Petrolera km 4 Zona Sud OTB Villa San Miguel, Cochabamba, Bolivia
| | - Leonardo Romero
- Dircetor of the Oral prostodontic department. Romedent dental clinic, Bogotá, Colombia
| | - Aldo Manzur Conte
- Director of endodontic department. Savanna Dental Group, 1135 Adelaide St. North suite 303, London, Ontario N5Y 5K7, Canada
| | - John M Wright
- Department of Diagnostic Sciences, Texas A&M University College of Dentistry, 3302 Gaston Ave, Dallas, TX 75246, United States
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3
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Differential Diagnosis between Oral Metastasis of Renal Cell Carcinoma and Salivary Gland Cancer. Diagnostics (Basel) 2021; 11:diagnostics11030506. [PMID: 33809250 PMCID: PMC7999008 DOI: 10.3390/diagnostics11030506] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/23/2021] [Accepted: 03/08/2021] [Indexed: 01/23/2023] Open
Abstract
Renal cell carcinoma, which has clear cells in 70% of cases, has a high frequency of hematogenous distant metastases to lung, bone, liver, and other areas. Metastatic cancer accounts for 1 to 3% of malignant tumors in the stomatognathic region, and the metastasis of renal cell carcinoma to the oral mucosal tissue, though extremely rare, does occur. In addition, clear cells have been observed in some salivary gland cancers in the oral cavity. Therefore, the differential diagnosis of metastatic renal cell carcinoma and salivary gland cancer is important. This review discusses the differential diagnosis between metastatic renal cell carcinoma and malignant tumors of the salivary gland.
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4
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Gudelj G, Simunjak T, Zizic M, Simunjak B, Jurlina M. An unusual case of hyalinizing clear cell carcinoma in a sinonasal cavity and cranial base. J Surg Case Rep 2020; 2020:rjaa436. [PMID: 33133509 PMCID: PMC7588309 DOI: 10.1093/jscr/rjaa436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/21/2020] [Accepted: 09/29/2020] [Indexed: 11/12/2022] Open
Abstract
Hyalinizing clear cell carcinoma (HCCC) is a rare, predominantly minor salivary gland tumor. Most of these tumors occur in the oral cavity, mainly the palate and tongue. Primary localization of the tumor in the region of the nasal cavity and paranasal sinuses is extremely rare and, with only a few cases reported in the literature so far. We present an extremely rare case of a 61-year-old woman with hyalinizing clear cell carcinoma (HCCC), occupying the left posterior nasal and nasopharyngeal cavity, as a primary tumor location. The patient total recovery was uneventful, and she is now free of disease at three years postoperative follow-up.
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Affiliation(s)
- Goran Gudelj
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Sveti Duh, Zagreb, Croatia
| | - Tena Simunjak
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Sveti Duh, Zagreb, Croatia
| | - Marica Zizic
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Sveti Duh, Zagreb, Croatia
| | - Boris Simunjak
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Sveti Duh, Zagreb, Croatia
| | - Martin Jurlina
- Department of Maxillofacial Surgery, University Hospital Dubrava, University of Zagreb School of Medicine, Zagreb, Croatia
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5
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Patel S, Barros J, Nwizu NN, Ogbureke KUE. Metastatic renal cell carcinoma to the oral cavity as first sign of disease: A case report. Clin Case Rep 2020; 8:1517-1521. [PMID: 32884786 PMCID: PMC7455456 DOI: 10.1002/ccr3.2923] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 03/25/2020] [Accepted: 04/10/2020] [Indexed: 12/30/2022] Open
Abstract
Renal cell carcinoma metastasis to the oral cavity is rare. Significantly, the oral lesion in this case was the first indication of a malignant disease in the patient. This case underscores the importance of detailed history taking, interpretation of clinical finding, and high index of suspicion for metastatic disease to the oral cavity.
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Affiliation(s)
- Shalizeh Patel
- Department of Restorative Dentistry & ProsthodonticsSchool of Dentistry at HoustonUniversity of Texas Health Science Center at HoustonHoustonTXUSA
| | - Juliana Barros
- Department of Restorative Dentistry & ProsthodonticsSchool of Dentistry at HoustonUniversity of Texas Health Science Center at HoustonHoustonTXUSA
| | - Ngozi N. Nwizu
- Department of Diagnostic & Biomedical SciencesSchool of Dentistry at HoustonUniversity of Texas Health Science Center at HoustonHoustonTXUSA
| | - Kalu U. E. Ogbureke
- Department of Diagnostic & Biomedical SciencesSchool of Dentistry at HoustonUniversity of Texas Health Science Center at HoustonHoustonTXUSA
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6
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Nisi M, Izzetti R, Graziani F, Gabriele M. Renal Cell Carcinoma Metastases to the Oral Cavity: Report of 2 Cases and Review of Literature. J Oral Maxillofac Surg 2020; 78:1557-1571. [PMID: 32386976 DOI: 10.1016/j.joms.2020.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 04/01/2020] [Accepted: 04/01/2020] [Indexed: 02/06/2023]
Abstract
The localization of renal cell carcinoma (RCC) metastases in the oral cavity has been reported, accounting for about 15% of patients with metastasizing renal disease. In this work, we report 2 cases of oral metastases of renal carcinoma and provide a review of the current literature on the occurrence of oral metastases of renal origin. The first patient (a 61-year-old man) presented with a tumefaction of the body of the tongue. The second patient (a 71-year-old man) showed a large mass localized in the buccal mucosa. In both patients, incisional biopsy was performed to better characterize the nature of the lesions. Histologic evaluation showed the metastatic origin of the 2 lesions, which were distant metastases of clear cell RCC. After systemic evaluation, a second surgical procedure was performed to obtain a wider resection of the mass to reduce the development of complications and improve the patients' quality-of-life. After the second surgical treatment, both patients showed an improvement in symptoms, and no further complications and/or signs of recurrence were detected. At present, 132 cases of oral metastases of RCC have been described in the literature. This article reviews and discusses the clinical, diagnostic, and pathologic features and the treatment options reported in the literature. Localization of renal metastases to the tongue was the most frequently described localization in the literature. In general, surgical treatment appears to be effective in controlling metastasis development and associated symptoms. Although relatively rare, renal metastases to the oral cavity should be taken into account when creating the differential diagnosis of oral lesions of unknown origin.
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Affiliation(s)
- Marco Nisi
- Assistant Professor, Department of Surgical Pathology, Medicine, Molecular and Critical Area, University of Pisa, Pisa, Italy.
| | - Rossana Izzetti
- PhD Student, Department of Surgical Pathology, Medicine, Molecular and Critical Area, University of Pisa, Pisa, Italy
| | - Filippo Graziani
- Full Professor, Department of Surgical Pathology, Medicine, Molecular and Critical Area, University of Pisa, Pisa, Italy
| | - Mario Gabriele
- Full Professor, Department of Surgical Pathology, Medicine, Molecular and Critical Area, University of Pisa, Pisa, Italy
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7
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Boulanger L, Gérard E, Curien R. Multiple gingival metastasis of renal cell carcinoma: a case report. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2019. [DOI: 10.1051/mbcb/2018037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction: Oral metastases are rare and represent only 1% of malignant diseases of the oral cavity, but they are often associated with poor prognosis. The primary tumor is recognizable in most cases; however, in 27.6% of cases, metastasis is the first clinical manifestation. Observation: An 82-year-old consulted for the recent appearance of a 1-cm-wide gingival tumor on 46. Since this patient had metastatic clear cell renal cell carcinoma, oral metastasis was confirmed by histopathology. In the following weeks, other oral metastases appeared. Palliative radiotherapy was the chosen treatment option, but the patient died before he could benefit from it. Discussion: Multiple oral metastases are rare, and metastasis of renal origin is not the most frequently encountered. The metastatic dissemination pathway described is hematogenous or lymphatic. Diagnosis is often easy if the primary tumor is already identified, but is a challenge if it is not, because the lesion often has a nonspecific appearance. Different surgical, radiotherapeutic, and medical therapeutic options exist, but are often palliative. A new immunotherapy route is under development and looks promising in the treatment of renal cell carcinoma. Conclusions: Oral metastasis often has poor prognosis, and management of the lesion is problematic. However, current research suggests a therapeutic and prognostic improvement.
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8
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Derakhshan S, Rahrotaban S, Mahdavi N, Mirjalili F. Metastatic renal cell carcinoma presenting as maxillary lesion: Report of two rare cases. J Oral Maxillofac Pathol 2018; 22:S39-S43. [PMID: 29491603 PMCID: PMC5824515 DOI: 10.4103/jomfp.jomfp_186_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Oral cavity is not a usual site for metastasis, accounting about 1% of all oral tumors. The majority site for metastasis is the mandible and less common the maxilla followed by intraoral soft tissue. These tumors may be the first clinical manifestation of the primary lesion. One of the most important sites of the primary neoplasm that metastasizes to the jaws is kidney. Therefore, considering to this fact that the metastatic tumors always are not seen in a typical site, it is necessary to rule out the metastatic carcinomas to jaws. We presented two cases of metastatic renal cell carcinoma to maxilla with two different clinical features, one of them with an intraosseous lytic lesion and the other one with a large exophytic mass.
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Affiliation(s)
- Samira Derakhshan
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Tehran, Iran
| | - Sedighe Rahrotaban
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Tehran, Iran
| | - Nazanin Mahdavi
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Tehran, Iran
| | - Faeze Mirjalili
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Tehran, Iran
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9
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Vasilyeva D, Peters SM, Philipone EM, Yoon AJ. Renal cell carcinoma metastatic to the maxillary gingiva: A case report and review of the literature. J Oral Maxillofac Pathol 2018; 22:S102-S107. [PMID: 29491617 PMCID: PMC5824500 DOI: 10.4103/jomfp.jomfp_69_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Tumor metastasis to the oral cavity is rare and is usually an indication of late-stage disease and poor prognosis. While, there are reports of renal cell carcinoma (RCC) metastatic to oral cavity, vast majority of them are to the jaw. Herein, we present a case of a 78-year-old woman with RCC metastasis limited to the oral soft tissue without any bone involvement. As the lesion solely involved maxillary gingiva, it clinically mimicked that of a pyogenic granuloma, which is a reactive, nonneoplastic condition. This case was further complicated as the patient was unaware of primary cancer and appeared to be in good physical health. Her oral metastasis marked the initial manifestation of an otherwise silent primary renal cancer.
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Affiliation(s)
- Daria Vasilyeva
- Division of Oral and Maxillofacial Pathology, Columbia University Medical Center, New York, USA
| | - Scott M Peters
- Division of Oral and Maxillofacial Pathology, Columbia University Medical Center, New York, USA
| | - Elizabeth M Philipone
- Division of Oral and Maxillofacial Pathology, Columbia University Medical Center, New York, USA
| | - Angela J Yoon
- Division of Oral and Maxillofacial Pathology, Columbia University Medical Center, New York, USA
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10
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Nifosì G, Bressand H, Nifosì AF, Nifosì L, Damseaux P. Epulis-Like Presentation of Gingival Renal Cancer Metastasis. Case Rep Oncol 2017; 10:758-763. [PMID: 28878662 PMCID: PMC5582523 DOI: 10.1159/000479500] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 07/17/2017] [Indexed: 01/17/2023] Open
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.
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Affiliation(s)
- Gianfilippo Nifosì
- Departement of Internal Medecine, Hemato-Oncology Clinic, Brugmann University Hospital Center, Brussels, Belgium
| | - Hubert Bressand
- Departement of Stomatology, Oral and Maxillo Facial Surgery, University Hospital Brugmann, Brussels, Belgium
| | | | | | - Pierre Damseaux
- Departement of Stomatology, Oral and Maxillo Facial Surgery, University Hospital Brugmann, Brussels, Belgium
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11
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Abstract
Metastases to the oral cavity are extremely rare events, representing less than 1% of all malignant oral tumors. Renal cell carcinoma constitutes about 3% of solid tumors in adults, and it is the most frequent kidney neoplasm, representing about 90% of kidney malignancies. Due to the silent growth of this neoplasm, most patients have no symptoms and the diagnosis is belated, usually after metastases. The present study reports an additional patient of metastatic renal cell carcinoma to the oral cavity regarding the clinical and pathologic features.
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12
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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: 31] [Impact Index Per Article: 3.9] [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.
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Affiliation(s)
- Soussan Irani
- Dental Research Center, Department of Oral Pathology, Dental Faculty, Hamadan University of Medical Sciences, Hamadan, Iran
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13
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Shah A, Jahan S, Najar L, Hassan S, Mohammad M. Metastatic clear cell variant of renal cell carcinoma of the mandible: Review and case report. Ann Maxillofac Surg 2016; 6:144-7. [PMID: 27563625 PMCID: PMC4979332 DOI: 10.4103/2231-0746.186121] [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] [Indexed: 11/08/2022] Open
Abstract
A case of metastatic renal cell carcinoma (RCC) to the mandible is reported. A 22-year-old man consulted us for hypoesthesia of the right lower lip. Panorama X-ray film showed a radiolucent lesion in the right mandibular body. A diagnosis of a metastatic tumor to the mandible from the right kidney was made after evaluation by computed tomography and bone scan with Tc99 methyl diphosphonate which also revealed multiple bone metastases. Histologically diagnosis was clear cell variant of RCC. Patient has been put on radiotherapy for symptomatic treatment and a molecularly targeted drug. The therapy effectively stopped the progressive growth of oral and other metastatic lesions. The quality of life is relatively well maintained with tolerable adverse effects. The patient is still on our follow-up with an improved quality of life.
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Affiliation(s)
- Ajaz Shah
- Department of Oral and Maxillofacial Surgery, Government Dental College, Srinagar, Jammu and Kashmir, India
| | - Shahi Jahan
- Department of Oral and Maxillofacial Surgery, Government Dental College, Srinagar, Jammu and Kashmir, India
| | - Latief Najar
- Department of Oral and Maxillofacial Surgery, Government Dental College, Srinagar, Jammu and Kashmir, India
| | - Shahid Hassan
- Department of Oral and Maxillofacial Surgery, Government Dental College, Srinagar, Jammu and Kashmir, India
| | - Manzoor Mohammad
- Department of Oral and Maxillofacial Surgery, Government Dental College, Srinagar, Jammu and Kashmir, India
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14
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Ali RA, Mohamed KE. Metastatic Clear Cell Renal Cell Carcinoma Presenting with a Gingival Metastasis. Clin Pract 2016; 6:847. [PMID: 27478584 PMCID: PMC4943104 DOI: 10.4081/cp.2016.847] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 04/20/2016] [Indexed: 11/23/2022] Open
Abstract
Metastatic deposits to the oral cavity are exceptionally rare. The commonest tumor types metastasizing to the oral cavity include lung and breast carcinoma. Renal cell carcinoma is believed to be the third most common infra clavicular tumor to metastasize to the head and neck. We report a case where an oral cavity deposit was the initial presentation for an occult clear cell renal carcinoma. Additional therapeutic options, including immunotherapy, tyrosine kinase inhibitors, and participation in a clinical trial, should be discussed with the patient despite the poor overall prognosis.
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Affiliation(s)
- Rusha A.E. Ali
- Department of Medical Oncology, Alneelain University, Khartoum, Sudan
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15
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Three Synchronous Atypical Metastases of Clear Cell Renal Carcinoma to the Maxillary Gingiva, Scalp and the Distal Phalanx of the Fifth Digit: A Case Report. J Oral Maxillofac Surg 2016; 74:1286.e1-9. [PMID: 26954558 DOI: 10.1016/j.joms.2016.01.054] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 01/26/2016] [Accepted: 01/28/2016] [Indexed: 11/22/2022]
Abstract
Oral cavity metastasis of malignant tumors is extremely rare and accounts for only 1% of all malignant oral tumors. Renal cell carcinoma (RCC) can metastasize to any part of the body, with a 15% risk of metastasis to the head and neck region when the disease is disseminated and a 1% risk when it is not. RCC also is the third most common infraclavicular neoplasm that metastasizes to the oral cavity, after lung carcinoma in men and breast carcinoma in women. In the maxillofacial region, the nasal cavity and paranasal sinuses are the most commonly affected sites, followed by the oral cavity. This report describes the case of a 51-year-old man with a history of clear RCC presenting with 3 synchronous atypical metastases of this tumor to the maxillary gingiva, scalp, and distal phalanx of the fifth digit. Clinical findings, diagnosis, pathology, and treatment of these lesions are discussed. Metastasis of RCC should always be included in the differential diagnosis when a new oral and maxillofacial lesion appears in a patient with a history of RCC because the metastatic lesions can often present in a broad spectrum of forms. The rapid growth of these lesions should alert clinicians to avoid any delays in biopsy examination and subsequent treatment, which is usually palliative, because prognosis is usually poor.
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16
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Kudva R, Nayal B, Kantipudi S, Ray S. Metastatic renal cell carcinoma of the buccal mucosa masquerading as a salivary gland neoplasm. J Oral Maxillofac Pathol 2016; 20:547. [PMID: 27721630 PMCID: PMC5051313 DOI: 10.4103/0973-029x.190967] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Metastasis to the oral cavity is a rare occurrence with renal cell carcinoma (RCC) being the third most common tumor to metastasize to this location. Buccal mucosa is rarely involved and in the absence of a known primary, such lesions pose a diagnostic challenge to the pathologist. The histomorphological features may mimic a primary salivary gland neoplasm adding to the dilemma. We present one such case of metastatic RCC of the buccal mucosa.
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Affiliation(s)
- Ranjini Kudva
- Department of Pathology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Bhavna Nayal
- Department of Pathology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Swarna Kantipudi
- Department of Radiodiagnosis, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Satadru Ray
- Department of Surgical Oncology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
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17
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Sawicki P, Kaźmierczak W, Burduk P, Kaźmierczak H. Multiple metastases of renal clear cell carcinoma to the organs of the head. Contemp Oncol (Pozn) 2014; 18:448-51. [PMID: 25784846 PMCID: PMC4355657 DOI: 10.5114/wo.2014.47474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 12/05/2013] [Accepted: 12/27/2013] [Indexed: 11/17/2022] Open
Abstract
Metastases of renal clear cell carcinoma to the organs of the head are rare. Single cases show that they can appear either shortly after or many years after radical surgery. The diagnosis of this cancer is difficult because of its insidious course; therefore, it is often diagnosed too late. Late diagnosis is associated with a high risk of distant metastases and increased mortality. The paper presents a case of a patient whose kidney tumour was diagnosed during hospitalisation at the Department of Rheumatology. Further diagnosis and surgical treatment were performed in the Department of Urology, where a left-sided nephrectomy was carried out. After two years, the patient was hospitalised in the Department of Otolaryngology due to dysphagia. The patient was subjected to fine-needle biopsy, surgical biopsy, CT, and ultrasound. Metastases of renal clear cell carcinoma were diagnosed based on a histopathological examination and the results of imaging studies. Due to the extent of the tumour, diagnostics were extended to magnetic resonance imaging. The patient was qualified for tracheotomy, cytoreductive surgery, and chemoradiation. The patient was referred for further treatment at the Centre of Oncology in Bydgoszcz.
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Affiliation(s)
- Piotr Sawicki
- Department of Otolaryngology, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland
| | - Wojciech Kaźmierczak
- Department of Otolaryngology, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland
| | - Paweł Burduk
- Department of Otolaryngology, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland
| | - Henryk Kaźmierczak
- Department of Otolaryngology, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland
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18
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Suojanen J, Färkkilä E, Helkamaa T, Loimu V, Törnwall J, Lindqvist C, Hagström J, Mesimäki K. Rapidly growing and ulcerating metastatic renal cell carcinoma of the lower lip: A case report and review of the literature. Oncol Lett 2014; 8:2175-2178. [PMID: 25289097 PMCID: PMC4186528 DOI: 10.3892/ol.2014.2505] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 05/23/2014] [Indexed: 12/14/2022] Open
Abstract
Renal cell carcinomas (RCCs) have a tendency to metastasize at an early stage, therefore, the patients frequently exhibit metastatic disease at the time of diagnosis. Common locations for the metastases are adjacent organs and abdominal lymph nodes; however, occasionally metastasis to the peripheral organs may be the initial clinical symptom. The 71-year-old male patient in the current case suffered from radioresistant and aggressively behaving RCC metastasis in the mandible and lower lip, which was successfully managed by surgical resection. RCC metastasis to the facial area is considered to be uncommon based on a review of the existing literature. RCC are somewhat radioresistant and therefore, palliative surgery must be considered when treating patients with this metastatic disease.
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Affiliation(s)
- Juho Suojanen
- Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki FIN-00014, Finland
| | - Esa Färkkilä
- Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki FIN-00014, Finland
| | - Tessa Helkamaa
- Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki FIN-00014, Finland
| | - Venla Loimu
- Department of Oncology, Helsinki University Central Hospital, Helsinki FIN-00014, Finland
| | - Jyrki Törnwall
- Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki FIN-00014, Finland
| | - Christian Lindqvist
- Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki FIN-00014, Finland
| | - Jaana Hagström
- The Haartman Institute, Department of Pathology and HUSLAB, Helsinki University Central Hospital, Helsinki FIN-00014, Finland
| | - Karri Mesimäki
- Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki FIN-00014, Finland
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19
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Beck-Broichsitter BE, Klapper W, Günther A, Wiltfang J, Becker ST. Gingival ulceration and exposed bone. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115:288-92. [DOI: 10.1016/j.oooo.2011.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2011] [Revised: 12/11/2011] [Accepted: 12/16/2011] [Indexed: 02/07/2023]
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20
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Etöz OA, Soylu E, Kiliç K, Günhan Ö, Akcay H, Alkan A. A reactive lesion (pyogenic granuloma) associated with dental implant: a case report. J ORAL IMPLANTOL 2012; 39:733-6. [PMID: 22214438 DOI: 10.1563/aaid-joi-d-11-00166] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Osman A Etöz
- 1 Department of Oral and Maxillofacial Surgery, Erciyes University, Melikgazi, Kayseri, Turkey
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Abstract
ABSTRACT
Clear cells are routinely encountered in the histopathological sections. They most frequently result from fixation artefacts; cytoplasmic accumulation of water, glycogen, lipids, mucins; hydropic degeneration of organelles, etc. When these clear cells predominate in a tumor, arriving at a definitive diagnosis becomes problematic. Thus, this review gives an idea of clear cells associated with various conditions, causes for clearing of these cells, clear cell tumors of the head and neck and a systematic approach towards arriving at an appropriate diagnosis of these tumors.
How to cite this article
Premalatha BR, Rao RS, Patil S, Neethi H. Clear Cell Tumors of the Head and Neck: An Overview. World J Dent 2012;3(4):344-349.
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22
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Dashow JE, Gemmete JJ, McHugh JB, Helman JI. Metastatic clear cell renal carcinoma of the palate mimicking noninvoluting congenital hemangioma. J Oral Maxillofac Surg 2010; 69:1836-41. [PMID: 21185638 DOI: 10.1016/j.joms.2010.07.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2010] [Accepted: 07/22/2010] [Indexed: 01/04/2023]
Affiliation(s)
- Jason E Dashow
- Department of Oral and Maxillofacial Surgery, University of Michigan Medical Center, Ann Arbor, MI, USA.
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