Hepatocellular Carcinomas Diagnosed Following Metastasis to the Oral Cavity. Report of 2 Cases

Llanes, Felipe; Sanz-Ortega, Julián; Suárez, Begoña Graña; Sanz-Esponera, Julián

doi:10.1902/jop.1996.67.7.717

Cited by 42 publications

(23 citation statements)

References 6 publications

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“…The most common primary site is lung carcinoma, followed in order by breast carcinoma and renal cell carcinoma [19,20]. HCC metastatic to the oral cavity is extremely rare; the author reviewed the literature and found only a few reported cases [21][22][23][24]. Shen et al [24] reported 19 cases of metastatic tumors to the oral and maxillofacial region.…”

Section: Discussionmentioning

confidence: 99%

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Hepatocellular Carcinoma Metastatic to the Gingiva as a First Manifestation of Hepatocellular Carcinoma

Terada

2011

J. Maxillofac. Oral Surg.

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A 55-year-old man consulted to our hospital complaining of a gingival tumor. Oral examination showed granulation tissue-like polypoid tumors (2 × 2 × 1 cm) in the left upper gingiva. A clinical diagnosis of granulation tissue was made, and an incisional biopsy was performed. It showed carcinoma cells in the submucosa. They were arranged in compact and sinusoidal patterns. A few bile plugs and one Mallory-like body were recognized by meticulous examination. An immunohistochemical study showed that the tumor cells were positive for hepatocyte paraffin-1 (HepPar-1), cytokeratins (AE1/3 and CAM6.2), and p53 protein. The carcinoma cells were negative for vimentin, prostate specific antigen, CD10, and α-fetoprotein. The Ki-67 labeling was 49%. A histological diagnosis of hepatocellular carcinoma (HCC) metastatic to the gingiva was made. Then, the patient was referred to hepatology unit. A blood laboratory test showed elevated elevated liver enzymes, and positive antibody to hepatitis C virus. Liver cirrhosis was also present. Imaging modalities including US, CT, and MRI revealed multiple hepatic tumors. Metastases to other sides were not recognized. The patient was diagnosed as cirrhosis and HCC with an extrahepatic metastasis to the gingiva. The patient was now treated by chemotherapy. The present case shows that HCC can manifest as small gingival tumors, and meticulous HE examination and immunoreactive HepPar-1 are useful in the diagnosis of HCC in extrahepatic metastatic sites.

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Section: Discussionmentioning

confidence: 99%

“…The most common metastatic malignancy of the oral cavity is lung carcinoma, followed in order by breast carcinoma, and renal cells carcinoma [19,20]. Metastatic HCC is extremely rare in the oral cavity [21][22][23][24]. The author herein reports on a case of an extrahepatic metastasis from HCC in the gingiva.…”

Section: Introductionmentioning

confidence: 99%

Hepatocellular Carcinoma Metastatic to the Gingiva as a First Manifestation of Hepatocellular Carcinoma

Terada

2011

J. Maxillofac. Oral Surg.

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“…To the best of our knowledge, only 13 such cases have been reported in the English literature to date (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). The pathogenesis of the metastasis of malignant tumors to the gingiva is unclear.…”

Section: A B C Dmentioning

confidence: 99%

“…Extrahepatic metastasis of HCC occurs in ~30-50% of patients (2)(3)(4)(5), and the most common metastatic sites are the lungs, abdominal lymph nodes and bones (2)(3)(4)(5). Metastasis to the gingiva is rare and, to the best of our knowledge, only 13 such cases have been reported in English literature thus far (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). The age range of these patients was 46-78 years and the average age was 61 years.…”

Section: Introductionmentioning

confidence: 99%

Hepatocellular carcinoma metastasis to the gingival soft tissues: A case report and review of the literature

Gong

Zhang

et al. 2015

Oncology Letters

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Abstract. Metastases to the gingival soft tissues are rare in hepatocellular carcinoma (HCC). To the best of our knowledge, only 13 cases have been reported in English literature to date. The present study described the case of a 43-year-old Chinese man who was admitted to Tangdu Hospital (Xi'an, China) due to the presence of a gingival tumor that was initially diagnosed as granulation tissue by a dental surgeon. Examination of the patient's medical history revealed that a solid mass, measuring 1.5 cm in diameter, was identified in the right lobe of the liver 2 years prior to presentation at the current hospital; however, no biopsy was performed. Thus, the tumor was resected and histological examination resulted in an initial diagnosis of atypical squamous cell carcinoma. However, the histopathological characteristics, immunohistochemical features and serum α-fetoprotein expression levels supported a diagnosis of metastatic HCC. In conclusion, the present case study highlights the difficulties in diagnosing metastatic HCC without a history of primary HCC, and the importance of excluding a diagnosis of metastatic tumor when a lesion is identified in the gingival. Furthermore, it was determined that a final diagnosis of gingival metastasis of HCC predominantly depends on pathological characteristics and immunohistochemical features.

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“…The most frequent sites of oral metastasis are the mandible and the gingival, 1-9 and a few cases of HCC metastasis in the palatine tonsil have been reported. 4, 10 We report a case of an isolated mesopharyngeal metastasis of HCC in a patient treated previously with liver resection, radiofrequency ablation (RFA), and transarterial chemoembolization (TAE). This is a rare case of a premortem-diagnosed pharyngeal metastasis, which was excised completely.…”

Section: Introductionmentioning

confidence: 99%

Hepatocellular carcinoma with pharyngeal metastasis: Report of a case

et al. 2008

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We report a case of pharyngeal metastasis of hepatocellular carcinoma (HCC). Any oral cavity involvement of HCC, especially pharyngeal metastasis, is extremely rare. The resected specimen contained a pedunculated polypoid lesion and histological examination revealed an epithelial tumor with a trabecular growth pattern, covered with intact squamous mucosa. Immunohistochemical studies were positive for hepatocyte-specific antigen and alpha-fetoprotein. At the time of writing, the patient, a 73-year-old man, was alive but with multiple recurrent lesions in the remnant liver, 1 year after resection of the pharyngeal metastasis. Oral metastases should be treated surgically or endoscopically if possible for the symptomatic relief of oral discomfort, pain, and bleeding; however, the prognosis is generally poor.

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Hepatocellular Carcinomas Diagnosed Following Metastasis to the Oral Cavity. Report of 2 Cases

Cited by 42 publications

References 6 publications

Hepatocellular Carcinoma Metastatic to the Gingiva as a First Manifestation of Hepatocellular Carcinoma

Hepatocellular Carcinoma Metastatic to the Gingiva as a First Manifestation of Hepatocellular Carcinoma

Hepatocellular carcinoma metastasis to the gingival soft tissues: A case report and review of the literature

Hepatocellular carcinoma with pharyngeal metastasis: Report of a case

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