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Metastasis of mesothelioma to the maxillary gingiva.

Ohnishi Y, Sugitatsu M, Watanabe M, Fujii T, Kakudo K - Oncol Lett (2014)

Bottom Line: Malignant mesothelioma predominantly arises from the serosal surfaces of the pleural or peritoneal cavity.However, metastasis to the oral gingiva is rare, as only four cases have previously been reported; two cases of metastasis to the tongue and four cases to the jaw bone.To the best of our knowledge, this is the first report regarding the metastasis of this type of neoplasm to the maxillary gingiva.

View Article: PubMed Central - PubMed

Affiliation: Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Osaka 540-0008, Japan.

ABSTRACT
Malignant mesothelioma predominantly arises from the serosal surfaces of the pleural or peritoneal cavity. There is currently no effective standard treatment for mesothelioma and the prognosis for patients is poor; the majority of patients with malignant mesothelioma succumb between 12 and 17 months following diagnosis. The association of all forms of malignant mesothelioma with asbestos exposure has been well documented. However, metastasis to the oral gingiva is rare, as only four cases have previously been reported; two cases of metastasis to the tongue and four cases to the jaw bone. In the current report, the case of a 62-year-old male with metastatic mesothelioma is presented. To the best of our knowledge, this is the first report regarding the metastasis of this type of neoplasm to the maxillary gingiva.

No MeSH data available.


Related in: MedlinePlus

Photomicrograph demonstrating a mixed-type diffuse mesothelioma with poorly differentiated epithelial and spindle cells. (Haematoxylin and eosin stain; magnification, ×100).
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f2-ol-08-03-1214: Photomicrograph demonstrating a mixed-type diffuse mesothelioma with poorly differentiated epithelial and spindle cells. (Haematoxylin and eosin stain; magnification, ×100).

Mentions: A 62-year-old male was referred to the physicians at the Department of Dentistry and Maxillofacial Surgery at the Osaka Red Cross Hospital (Osaka, Japan), in November 1996, with a two-month history of progressive shortness of breath on exertion. Clinical and radiographic examination revealed a left-sided pleural effusion, which was drained successfully. A chest radiograph and computed tomography demonstrated the presence of a mass in the left lung field, and a rigid bronchoscopy and open pleural biopsy showed the lesion to be a diffuse mesothelioma. At that time, the patient commenced radiotherapy (total dose, 40 Gy). However, two months after the initial presentation, the patient was referred to the Department of Dentistry and Maxillofacial Surgery, Osaka Red Cross Hospital(Osaka, Japan) with a large, painless mass on the maxillary gingiva. This mass had been present and growing gradually for two weeks. On examination a semi-hard, haemorrhagic lesion was found surrounding the molar teeth, and extending to the buccal and lingual aspects of the alveolar region (Fig. 1). The mobility of the affected teeth was good and radiographic examination revealed loss of the crestal bony architecture. An incisional biopsy was performed under local anaesthetic, and histology of the excised specimen showed a mixed-type diffuse mesothelioma with poorly differentiated epithelial and spindle cells (Fig. 2). The histological appearances of the biopsy specimen were identical to those that were observed in the previous pleural biopsy and immunocytochemistry indicated a sarcomatous, rather than carcinomatous, pattern with strong positivity for vimentin (Fig. 3). Focal positivity for cytokeratin, and negative reactions for carcinoembryonic antigen and epithelial membrane antigen were observed and an incisional biopsy was subsequently conducted. The tumour increased rapidly and the patient was unable to eat, thus, the tumour was removed to improve quality of life (QOL). The excised specimen revealed a solid semi-hard tissue mass (size, 30×25×20 mm), which was white-yellow in colour on the cut surface. Despite surgery, the patient succumbed 35 days later following deterioration of his medical condition.


Metastasis of mesothelioma to the maxillary gingiva.

Ohnishi Y, Sugitatsu M, Watanabe M, Fujii T, Kakudo K - Oncol Lett (2014)

Photomicrograph demonstrating a mixed-type diffuse mesothelioma with poorly differentiated epithelial and spindle cells. (Haematoxylin and eosin stain; magnification, ×100).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4114704&req=5

f2-ol-08-03-1214: Photomicrograph demonstrating a mixed-type diffuse mesothelioma with poorly differentiated epithelial and spindle cells. (Haematoxylin and eosin stain; magnification, ×100).
Mentions: A 62-year-old male was referred to the physicians at the Department of Dentistry and Maxillofacial Surgery at the Osaka Red Cross Hospital (Osaka, Japan), in November 1996, with a two-month history of progressive shortness of breath on exertion. Clinical and radiographic examination revealed a left-sided pleural effusion, which was drained successfully. A chest radiograph and computed tomography demonstrated the presence of a mass in the left lung field, and a rigid bronchoscopy and open pleural biopsy showed the lesion to be a diffuse mesothelioma. At that time, the patient commenced radiotherapy (total dose, 40 Gy). However, two months after the initial presentation, the patient was referred to the Department of Dentistry and Maxillofacial Surgery, Osaka Red Cross Hospital(Osaka, Japan) with a large, painless mass on the maxillary gingiva. This mass had been present and growing gradually for two weeks. On examination a semi-hard, haemorrhagic lesion was found surrounding the molar teeth, and extending to the buccal and lingual aspects of the alveolar region (Fig. 1). The mobility of the affected teeth was good and radiographic examination revealed loss of the crestal bony architecture. An incisional biopsy was performed under local anaesthetic, and histology of the excised specimen showed a mixed-type diffuse mesothelioma with poorly differentiated epithelial and spindle cells (Fig. 2). The histological appearances of the biopsy specimen were identical to those that were observed in the previous pleural biopsy and immunocytochemistry indicated a sarcomatous, rather than carcinomatous, pattern with strong positivity for vimentin (Fig. 3). Focal positivity for cytokeratin, and negative reactions for carcinoembryonic antigen and epithelial membrane antigen were observed and an incisional biopsy was subsequently conducted. The tumour increased rapidly and the patient was unable to eat, thus, the tumour was removed to improve quality of life (QOL). The excised specimen revealed a solid semi-hard tissue mass (size, 30×25×20 mm), which was white-yellow in colour on the cut surface. Despite surgery, the patient succumbed 35 days later following deterioration of his medical condition.

Bottom Line: Malignant mesothelioma predominantly arises from the serosal surfaces of the pleural or peritoneal cavity.However, metastasis to the oral gingiva is rare, as only four cases have previously been reported; two cases of metastasis to the tongue and four cases to the jaw bone.To the best of our knowledge, this is the first report regarding the metastasis of this type of neoplasm to the maxillary gingiva.

View Article: PubMed Central - PubMed

Affiliation: Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Osaka 540-0008, Japan.

ABSTRACT
Malignant mesothelioma predominantly arises from the serosal surfaces of the pleural or peritoneal cavity. There is currently no effective standard treatment for mesothelioma and the prognosis for patients is poor; the majority of patients with malignant mesothelioma succumb between 12 and 17 months following diagnosis. The association of all forms of malignant mesothelioma with asbestos exposure has been well documented. However, metastasis to the oral gingiva is rare, as only four cases have previously been reported; two cases of metastasis to the tongue and four cases to the jaw bone. In the current report, the case of a 62-year-old male with metastatic mesothelioma is presented. To the best of our knowledge, this is the first report regarding the metastasis of this type of neoplasm to the maxillary gingiva.

No MeSH data available.


Related in: MedlinePlus