Colorectal Carcinoma with Metastasis to Oral Mucosa; Two Cases Report

Oral metastasis of tumours is known to cause 1% of all oral malignancies and is most often the result of a primary in lung, breast and kidney [1,2]. The location of the metastasis is usually the jaw bones as opposed to soft tissues. A metastasis from colorectal adenocarcinoma to the soft tissues is hence extremely infrequent. The gingivae (55%) followed by the tongue (30%) are the most common soft tissue sites affected by metastatic tumour in the mouth [3]. The diagnosis of such cases is dependent on adequate history taking and although has a poor prognosis but early detection and effective treatment are necessary to aid in treatment and follow up. Here we report two cases of colorectal adenocarcinoma that metastasized to the oral gingiva and were diagnosed by histology and supportive immunohistochemistry.

Oral metastasis intraosseous mimicking periapical lesion: a case report

ABSTRACT Jaw metastasis can be mistaken for inflammatory or infectious diseases. Then, they should be considered in the differential diagnosis of unknown jaw lesions. Study reported here involved metastasis of breast cancer in the mandible of a 45-year-old woman. The most important differential diagnostic was a reactive lesion in an unusual periapical location associated with a nonvital tooth. However, given patient’s medical history and because paresthesia and pain were observed a few days after pulpectomy, metastasis of breast cancer could not be ruled out. When bone scintigraphy suggested the metastasis of a malignant bone tumor, incisional biopsy was performed. Histopathologic examination and immunohistochemical reaction confirmed the diagnosis of metastasis of breastcancer, and chemotherapy was thus performed as well. Unfortunately, patient died 2 years after diagnosis. Dentists as well as general physicians should therefore consider presence of oral metastasis in cases involving atypical symptoms, especially in patients with known malignant disease.

Oral metastasis of pulmonary adenocarcinoma: diagnosis and treatment

Introduction: Oral metastases are rare and represent 1% oro-facial neoplasms. The lung is the most common primary site for oral metastatic tumors. The diagnosis is based on histological analysis. Oral metastases have been associated with poor prognosis and is no longer a proven treatment. It was found in a 58-year old man diagnosed with lung cancer with a voluminous mandibular tumefaction following dental avulsion. The panoramic X-ray showed an area of ​​osteolysis compared to the extraction site. The histological and immunohistochemistry of the lesion showed a positivity of the marker CK7 and a negativity of TTF1, in favor of a lung origin. The biomolecular analysis revealed a mutation on the BRAF gene confirming the metastasis primitive origin. Treatment by surgical resection was performed palliatively. Comments: The diagnosis of an oral metastasis remains difficult and is based on the histological analysis and finding immune markers. Molecular biology is sometimes required for theranostics. Treatment options include surgical resection, radiotherapy, and/or chemotherapy. They are sometimes limited to preserve the quality of life. The prognosis of patients with oral metastases is very poor. Conclusion: Oral metastases are rare, and the diagnosis remains difficult.