Metastatic colonic adenocarcinoma presenting in the oral cavity: Disease progression over time

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology Pub Date : 2025-06-20 DOI:10.1016/j.oraloncology.2025.107440

Moisés Willian Aparecido Gonçalves , Gustavo de Souza Vieira , Nádia Cacita , Marcelo Elias Schempf Cattan , Carlos Takahiro Chone , Erika Said Abu Egal , Albina Altemani , Fernanda Viviane Mariano

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Abstract

A 55-year-old female patient with a history of colonic adenocarcinoma and metastases to the liver, retroperitoneum, lungs, and 11th rib (T3N1M1, clinical stage IVc) was referred for evaluation of a painful lesion in the retromolar trigone. Surgical intervention, chemotherapy, and radiotherapy were mentioned in the medical history for the intestinal condition. Extraoral examination revealed a hardened enlargement on the left hemiface. Intraoral examination showed a vegetative, ulcerative, infiltrative, and bleeding lesion in the left retromolar trigone. Computed tomography demonstrated an expansive lesion with a lytic component and cortical discontinuity in the left ascending mandibular ramus. An incisional biopsy revealed a proliferative epithelial component characterized by irregular tubular structures lined by columnar cells with variable pleomorphism. The tumor cells proved negative for CK7 and positive for CK20, which, combined with diffuse positivity for CDX2, confirmed that the cancer originated primarily in the intestinal epithelium. The Ki-67 index was 90 %. These findings confirmed the diagnosis of metastatic colonic adenocarcinoma to the oral cavity. At the time of the diagnosis of the oral metastasis, 52 months after the initial diagnosis, the patient was already receiving palliative treatment.

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在口腔出现的转移性结肠腺癌：疾病随时间的进展

一位55岁的女性患者，有结肠腺癌病史，并转移到肝脏、腹膜后、肺和第11肋骨（T3N1M1，临床分期IVc），我们对磨牙后三角区疼痛病变进行了评估。病史中有手术、化疗和放疗的记载。口外检查显示左半边脸硬化肿大。口腔内检查显示左侧磨牙后三角区有植物性、溃疡性、浸润性和出血病变。计算机断层扫描显示左侧下颌升支有一个扩张性病变，伴有溶解性成分和皮质不连续。切口活检显示增生性上皮成分，其特征是不规则管状结构，内衬柱状细胞，具有可变多形性。肿瘤细胞CK7表达阴性，CK20表达阳性，结合CDX2弥漫性阳性，证实肿瘤主要起源于肠上皮。Ki-67指数为90%。这些结果证实了口腔转移性结肠腺癌的诊断。在诊断为口腔转移时，在最初诊断后52个月，患者已经接受姑息治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oral oncology 医学-牙科与口腔外科

CiteScore

8.70

自引率

10.40%

发文量

505

审稿时长

20 days

期刊介绍： Oral Oncology is an international interdisciplinary journal which publishes high quality original research, clinical trials and review articles, editorials, and commentaries relating to the etiopathogenesis, epidemiology, prevention, clinical features, diagnosis, treatment and management of patients with neoplasms in the head and neck. Oral Oncology is of interest to head and neck surgeons, radiation and medical oncologists, maxillo-facial surgeons, oto-rhino-laryngologists, plastic surgeons, pathologists, scientists, oral medical specialists, special care dentists, dental care professionals, general dental practitioners, public health physicians, palliative care physicians, nurses, radiologists, radiographers, dieticians, occupational therapists, speech and language therapists, nutritionists, clinical and health psychologists and counselors, professionals in end of life care, as well as others interested in these fields.