Metastatic rectal adenocarcinoma in the mandibular gingiva: a case report

Abstract

BackgroundOral metastatic tumor from a rectal adenocarcinoma is very uncommon. The primary site is usually assumed based on the past clinical history. In the case of oral metastatic tumors, they commonly have a poor prognosis because often they have already spread to other sites.Case presentationWe present the case of a 64-year-old male patient with secondary metastasis to the mandibular gingiva via lung metastasis after the surgical resection of a primary rectal adenocarcinoma. The gingival lesion grossly appeared as a swollen mass, making mastication difficult. The patient received palliative radiotherapy for the mandibular mass lesion. However, tumor reduction was accompanied by the development of pneumonia and deterioration of the patient’s cachexia. Thus, the radiotherapy was discontinued but the patient died 2 months postradiotherapy. In the long term after its primary resection, the rectal adenocarcinoma was deduced to have finally metastasized to the oral region.ConclusionsIn this case, we consider a distant secondary metastasis to the oral region from a rectal malignancy. In such cases, careful clinical and pathologic evaluations are necessary, with careful consideration of the inclusion of palliative treatment in the therapeutic management.

Intestinal-type Adenocarcinoma Presenting as a Mandibular Mass

“…Intestinal-type adenocarcinoma rarely causes metastasis to mandible. [ 2 ] Metastatic spread can occur through hematogenous route, transcoelemic permeation, lymphatic route, local infiltration or a combination of the above. [ 10 ] Mandible is more commonly metastasized as it usually spreads through hematogenous route; and involves the posterior mandible which is rich in marrow spaces.…”

“…[ 1 ] It is an aggressive lesion that can metastasize to various parts of the body including upper airways, lungs, ethmoid sinus, nasal cavity, maxillary antrum, orbit, and skull base, but is infrequently seen involving the mandible. [ 2 ] Various malignancies can metastasize to oral region, but intestine is not the most common primary site. The spread of such lesions intraorally is an indicator of its poor prognosis.…”

Successful management of rare gingival metastasis from gastric adenocarcinoma: a case report and literature review

“…In this case, the similar cellular morphology and immunoreactivity of CK7, CK20, Villin, and MUC2 demonstrated the gingival metastasis originated from his gastric carcinoma. The upper gastrointestinal tract adenocarcinomas had been reported to be positive for both CK7 and CK20 in 78% of cases [ 14 ]. And MUC2 and Villin are also important gastric epithelial cell markers for phenotypical and histological detection of gastric cancer [ 15 ].…”

Maxillary Gingival Metastasis from Adenocarcinoma Colon

“…Oral cavity metastasis from colorectal cancers are rare. Most of the metastatic lesions occur in jaw bones [2], but cases of gingival metastasis also have been reported [3][4][5][6][7][8][9][10][11][12]. Most of the reported cases of gingival metastases are from mandibular gingiva.…”