Cases of gingival metastasis from lung cancer and a review of the literature

Abstract

Case 1: A 82-year old man was admitted with cough and bloody sputum. Chest roentgenogram showed a mass in the right upper lobe and bilateral pleural effusion. Cytology from right pleural effusion revealed adenocarcinoma. A left gingival tumor emerged 1.5 months after his discharge, and he died two and a half months later. Autopsy revealed a metastatic tumor to the left upper gingiva from lung carcinoma. Case 2: A 71-year old man was admitted with bloody sputum. Although chest roentgenogram showed a mass in the right lower lobe, neither transbronchial biopsy nor percutaneous biopsy yielded a definitive diagnosis. A right lower gingival tumor appeared, and the biopsy was interpreted as rhabdomyosarcoma. He died 5 months later due to metastatic brain tumors and respiratory failure. Autopsy revealed primary lung carcinoma (pleomorphic (spindle/giant cell) carcinoma) with gingival metastasis. Case 3: A 63-year old man was admitted with a right upper gingival tumor. Chest roentgenogram showed a mass in the right lower lobe. Primary lung carcinoma was diagnosed (poorly differentiated adenocarcinoma) with gingival metastasis. He died of respiratory failure due to uncontrolled malignant pleural effusion 1.5 months later. A literature survey of gingival metastases from lung cancer revealed that most cases were poorly differentiated lung cancer and prognosis was very poor. In several cases, irradiation and chemotherapy were effective. Therefore, those treatment regimens should be considered for gingival metastases in early stage cases.