Oral metastasis of renal cell carcinoma mimicking recurrence of excised malignant myoepithelioma: A case report

Abstract

Following breast and lung cancers, renal cell carcinoma (RCC) is the third most frequent cancer to metastasize to the head and neck region, though such cases are rarely reported. Distinguishing between malignant tumors of salivary gland origin and metastatic RCC is very important. The case of a 75-year-old man with an oral cavity lesion in the left buccal submucosa measuring 40×30 mm that had grown substantially over several weeks is presented. His medical history included left kidney cancer 26 years earlier and a malignant myoepithelioma of the left buccal region 7 years earlier. It was suspected that this lesion was a recurrent malignant myoepithelioma as it appeared at the same site as the previous operation. Surgery was performed, and metastatic RCC was confirmed upon pathological examination. The diagnosis of metastatic RCC was made by immunohistochemical examination, which also excluded malignant myoepithelioma and other clear cell carcinomas of salivary gland origin. Metastatic RCC must be considered in the differential diagnosis of a new oral cavity lesion presenting in a patient with a past history of kidney cancer. Thus, immunohistochemical staining is required to distinguish malignancies of salivary gland origin, including malignant myoepithelioma, from metastatic RCC.

Granulomatous Lesion in Inserted Gum-Metastasis of Renal Clear Cell Carcinoma. Case Presentation

“…Por otro lado, las lesiones metastásicas en cavidad bucal son raras, representando aproximadamente el 1% de todas las neoplasias malignas orales (1)(2)(3)7,12,14,22,23,30,33,34), lo que determina ser un sitio inusual y coincide con lo publicado por Allon et al (31) en relación a que las metástasis en cavidad bucal no son el sitio preferido para colonización metastásica debido a que es una propagación secundaria desde otra lesión metastásica como los pulmones. Aunque Murillo et al (35) mencionan que cualquier tumor maligno puede hacer metástasis en cavidad bucal, pero tales lesiones se asocian más comúnmente con ciertas neoplasias.…”

“…Sin embargo, en México su incidencia aproximada es de 1.86% considerando todas las neoplasias malignas al año (5,13). Se presenta con mayor frecuencia en el sexo masculino (5,10,12,14,15,16) en una proporción hombre-mujer 2:1 respectivamente y entre la quinta y séptima década de la vida (5,10).…”

“…La nefrectomía radical es considerada la única opción de tratamiento relativamente curativa en pacientes con enfermedad localizada (5,18) al proporcionar aproximadamente un 96% de supervivencia a 5 años (5); no obstante, en la actualidad no se ha comprobado la efectividad de la radioterapia adyuvante, quimioterapia o inmunoterapia como parte del tratamiento primario en estos pacientes (18). Aproximadamente un tercio de los pacientes con diagnóstico de carcinoma de células renales presentan metástasis (14,19) y la mitad de estos casos son metástasis a distancia (14) debido a su alta vascularización (20). Los sitios más frecuentes de metástasis a distancia del carcinoma de células renales son pulmones en un 50%, ganglios linfáticos 35%, huesos e hígado 30% (5,9,14,21) y con menor frecuencia la región de cabeza y cuello en un 15% cuando la enfermedad es diseminada (4,12,22,23) y 1% cuando es localizada (1,12,15,16).…”

Metastatic renal cell carcinoma to the oral cavity as first sign of disease: A case report

“…[1][2][3][4] In order of frequency, metastatic breast carcinomas to the oral cavity rank highest, followed by lung and kidney cancers. 5,6 Metastasis develops in approximately one-third of renal cell carcinomas (RCC), and approximately one-half of these are distant metastases following an initial primary site diagnosis. 6 Reports of metastatic renal cell carcinoma to the oral cavity presenting as first sign of disease are rare and indicate very poor prognosis.…”

“…5,6 Metastasis develops in approximately one-third of renal cell carcinomas (RCC), and approximately one-half of these are distant metastases following an initial primary site diagnosis. 6 Reports of metastatic renal cell carcinoma to the oral cavity presenting as first sign of disease are rare and indicate very poor prognosis. 7 Here, we present a case of metastatic RCC to the left buccal mucosa of a 59-year-old woman, which represented the first sign of the disease.…”