A challenging diagnosis: Case report of oral metastasis from gastric adenocarcinoma mimicking pyogenic granuloma

作者：Soares Ciro Dantas^*; Rocha Breno Amaral; Ribeiro Paranaiba Livia Maris; de Melo Filho Mario Rodrigues; Jorge Jacks; Freire de Carvalho Maria Goretti; de Almeida Oslei Paes

来源：Medicine, 2018, 97(13): e9934.

DOI：10.1097/MD.0000000000009934

• gastric carcinoma
• immunohistochemistry
• metastasis
• oral cavity

Rationale:Oral metastases occur more commonly in bone, but can also manifest in soft tissues and eventually resemble a reactive lesion. Few cases of oral metastases mimicking reactive lesions in soft tissues have been reported to date.Patient concerns:We report a metastasis of gastric carcinoma (GC) to the oral mucosa without bone involvement in a 43 yom clinically and microscopically mimicking a reactive lesion. The patient related that the lesion had 1 month of evolution, and the ulcerated area suggested the lesion was related to trauma.Diagnoses:The histopathological examination of the lesion revealed an exuberant granulation tissue with few neoplastic cells, and the initial diagnosis of pyogenic granuloma was considered. In a second analysis, clusters of clear cells morphologically similar to degenerating mucous cells or macrophages, positive for Cytokeratin (CK)-20, and CDX2 were found. At the moment, it was confirmed the presence of a primary GC in the patient.Interventions:A palliative radiotherapy/chemotherapy was started.Outcomes:However, the patient died 3 months after the diagnosis of oral metastasis.Lessons:This report highlights the importance of careful clinical and microscopic examinations in cases of oral metastasis that may mimic a reactive lesion.

• 出版日期2018-3