Oral metastasis of pulmonary adenocarcinoma: Diagnosis and treatment

Abstract

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. Oralmetastases 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 Xray 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.