Metastatic rectal adenocarcinoma in the mandibular gingiva: a case report

World J Surg Oncol. 2016 Jul 29;14(1):199. doi: 10.1186/s12957-016-0958-6.

Abstract

Background: Oral 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 presentation: We 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.

Conclusions: In 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.

Keywords: Gingiva; Metastasis; Rectal adenocarcinoma.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / metabolism*
  • Adenocarcinoma / surgery
  • Biopsy
  • Cachexia / etiology
  • Fatal Outcome
  • Gadolinium / administration & dosage
  • Gingiva / diagnostic imaging
  • Gingiva / pathology*
  • Gingival Neoplasms / diagnostic imaging
  • Gingival Neoplasms / radiotherapy
  • Gingival Neoplasms / secondary*
  • Humans
  • Lung Neoplasms / radiotherapy
  • Lung Neoplasms / secondary*
  • Lung Neoplasms / surgery
  • Magnetic Resonance Imaging
  • Male
  • Mandible / diagnostic imaging
  • Mandible / pathology
  • Mandibular Neoplasms / secondary
  • Middle Aged
  • Palliative Care / methods*
  • Pneumonectomy
  • Prognosis
  • Radiation Pneumonitis / etiology
  • Radiotherapy / adverse effects
  • Rectal Neoplasms / pathology*
  • Rectal Neoplasms / surgery
  • Spinal Neoplasms / diagnostic imaging
  • Spinal Neoplasms / radiotherapy
  • Spinal Neoplasms / secondary
  • Tomography, X-Ray Computed
  • Withholding Treatment

Substances

  • Gadolinium