Metastatic Tumors of the Oro-Facial Tissues: Clear Cell Renal Cell Carcinoma. A Clinico-Pathological and Immunohistochemical Study of Seven Cases

Abstract

Metastases to orofacial tissues are infrequent, their incidence being 1%–8% of malignant oral tumors, sometimes manifesting as the first clinical sign of an occult cancer. Renal cell carcinoma (RCC) is the second most common metastatic carcinoma to the oro-facial tissues, involving the jawbones, gingiva, oral mucosa, tongue or salivary glands. Also, RCC frequently displays a prominent clear cell component, which may predominate in the clear cell renal cell carcinoma subtype (CCRCC) and histologically mimic many other clear cell tumors, both benign and malignant, which can be epithelial (from keratinizing epithelia, cutaneous adnexa, salivary glands and odontogenic epithelium), melanocytic or mesenchymal in origin. In view of the necessity for prompt and accurate diagnosis of such unusual neoplasms, we report on the salient clinico-pathological features of 7 CCRCC metastatic to the oro-facial tissues, and highlight their immunohistochemical profile, to more accurately discriminate this neoplasm from other tumors of the oral cavity with a prominent clear cell component.

Metastatic Lung Cancer to the Head and Neck: A Clinico-Pathological Study on 21 Cases with Narrative Review of the Literature

“…In the current study, seven metastases involved submandibular lymph nodes, thus confirming them as an elective target for lymphogenous metastatic LCs. Their clinical identification is very difficult to achieve, as the differential diagnosis includes inflammatory diseases of the major salivary glands and lymph nodes, equally characterized by a similar unspecific clinical presentation, with painless/painful rapid swelling of a variable consistence too; moreover, benign and malignant primary tumors are certainly to be considered in the diagnostic work-up [ 2 , 7 , 8 , 9 ].…”

“…Metastases to the oro-facial tissues may involve the oral mucosa (mostly the gingiva and more rarely the tongue, with a prevalence of 0.17%), the jawbones (especially the mandible), the salivary glands, the soft tissues and the post-extraction sites. The most common primary site may differ on the basis of gender; in males, the most frequent origin of oro-facial metastases is the lung, followed by the kidney, prostate and colon-rectum, while in females it is the uterus, followed by the breast, lung and ovary [ 4 , 5 , 8 , 9 , 10 , 11 , 12 ]. Adenocarcinoma is the most common histologic type of primary lung cancer (LC), which is furthermore showing an increasing incidence worldwide [ 13 ].…”

Diode Laser Management of Primary Extranasopharyngeal Angiofibroma Presenting as Maxillary Epulis: Report of a Case and Literature Review

“…Conversely, JNAs with maxillary involvement, with or without extension into the oral cavity, are more easily diagnosable, and an incisional biopsy is performable in most cases. Nevertheless, the differential diagnosis remains extremely challenging, especially for the presence of undefined radiological borders, thus including benign/malignant epithelial and odontogenic neoplasms, benign and malignant maxillary/nasal sinuses neoplasms, localizations of hematological malignancies and metastatic tumors [ 6 , 36 , 37 , 38 , 39 , 40 , 41 ].…”

Oral and Maxillo-Facial Manifestations of Systemic Diseases: An Overview

“…The most frequent primary tumour occurs in the lung, kidney, prostate and colon-rectum in males, while in the breast, lung, uterus and ovary in females. Oro-facial metastases to the tissues can involve the oral mucosa, jawbones or the salivary glands may be variably involved also as first sign of a still occult cancer or manifestation of disseminated disease [ 176 , 177 , 178 ]. Also, a predilection of metastases for specific sites in the oro-facial region is generally well recognized (especially the molar and premolar regions by virtue of their richer vascularization and higher bone marrow content); this is also probably influenced by peculiar clinical conditions of oral hard and soft tissue, such as parodontal tissues with inflammatory lesions of dentates, or gingival tissues in edentulous individuals bearing prosthesis, or post-extractive sites probably as a consequence of increased blood flow following organization of the blood cloth [ 174 , 178 , 179 , 180 ].…”