Oral metastasis of uterine carcinoma: Case report and 83-year review of this uncommon occurrence

Abstract

Uterine cervix cancer is the second most common female cancer and the third most common cause of female cancer mortality. The disease spreads into the surrounding tissues by direct infiltration, whereas, spread by hematogenous dissemination is relatively unusual and the involvement of oral and maxillofacial region is extremely rare in gynecological cancer. A 72-year-old Chinese woman was referred to our dental clinic with a 4-month history of a painful and gradually expanding swelling in oral cavity associated with a severe limitation of mouth opening. The submucosa was fibro-elastic with normal mucosal covering on the left side of the soft palate that extended up to the palatoglossal arch, measuring 2.5 cm in maximum diameter. Fine needle aspiration cytology was performed on the nodule and the cytological diagnosis was consistent with undifferentiated carcinoma. An incisional biopsy was performed and the diagnosis of undifferentiated carcinoma of primary unspecified location was made. The patient’s son reported that his mother had been experiencing the return of her “menstrual cycle” so we referred her to the gynecologist who detected a lesion in the cervix uteri, bigger than the one in the oral cavity. Both lesions had the same histological and immunohistochemical profile prompting us to report this case as carcinoma of the cervix uteri that metastasized to the oral cavity. Unfortunately, the patient died 24 months after the initial diagnosis of the oral metastasis. The patient received sessions of radiotherapy exclusively in both lesions. The review of literature showed that oral metastasis from uterine cervix carcinoma is rare, indicating poor prognosis and that the correlation of clinical medical history, laboratory, imagenological, cytological, histopathological and immunohistochemical exams are essential for achievement of the precise diagnosis