A case report of metastasis of malignant mesothelioma to the retromolar trigone

Our plain-English summary of A case report of metastasis of malignant mesothelioma to the retromolar trigone, by A. Arslan, C. Ozcakir-Tomruk, E. Deniz, et al (World Journal of Surgical Oncology, 2016).

The study

• Authors: A. Arslan, C. Ozcakir-Tomruk, E. Deniz, O. Akin
• Journal: World Journal of Surgical Oncology
• Published: 2016;14(1):188
• Type of article: Case report
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Malignant mesothelioma is a rare and aggressive tumor with a poor prognosis. Distant metastases are very rare, and the oral cavity metastases are exceedingly rare. Only a few cases with metastasis to oral gingiva are reported. To our knowledge, this is the first case report of pleural mesothelioma metastasized to the retromolar trigone.

Case Presentation: A 59-year-old male was referred with a painless growth at retromolar trigone area. It had been present for 2 months and had increased in size during this period of time. Past medical history revealed a malignant mesothelioma. Intraoral examination showed a soft, haemorrhagic, ulcerated lesion at the right retromolar trigone area. There was no destruction of the bony architecture. An incisional biopsy was performed under local anaesthesia. Based on the histopathological and immunohistochemical findings, a final diagnosis of metastatic mesothelioma was made. The patient was informed about the possibility of multiple metastases within the body, but he succumbed after 45 days following deterioration of his medical condition.

Conclusions: Biopsy, history of the patient and clinical picture were provided to the clinicians to make an efficient differential diagnosis. Differential diagnosis must be performed with other oral cancers, because the management is totally different.

In plain English

This article was a case report of one patient, a 59-year-old man seen at the Department of Oral and Maxillofacial Surgery of Yeditepe University in Istanbul, Turkey. He had malignant pleural mesothelioma, diagnosed in September 2011 and treated with chemotherapy and radiotherapy. A PET scan in August 2013 showed the tumor in the left lung and a possible spread to the C7 vertebra. In January 2014 he was referred with a painless growth at the right retromolar trigone, a mouth area behind the last lower molar. It had been present for 2 months and had grown. It was soft, bleeding and ulcerated, with no damage to the bone. A biopsy showed cells that stained strongly for calretinin, and the final diagnosis was metastatic mesothelioma. He died 45 days later after his condition worsened. The article did not describe any asbestos exposure for this patient. The authors called this, to their knowledge, the first report of pleural mesothelioma spreading to this site. They concluded that it must be told apart from other oral cancers because treatment is different.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case report (one patient)
• Who was studied: One 59-year-old man with a history of malignant pleural mesothelioma, referred to the Department of Oral and Maxillofacial Surgery, Yeditepe University, Istanbul, Turkey, in January 2014
• Exposure: Not reported. The article gives no asbestos or other exposure history for this patient.
• Main results:
  • The patient's malignant mesothelioma was diagnosed in September 2011 and was treated with chemotherapy and radiotherapy.
  • PET imaging in August 2013 showed the tumor in the left lung and a possible metastasis in the C7 vertebra.
  • In the mouth there was a soft, haemorrhagic, ulcerated lesion at the right retromolar trigone area. It had been present for 2 months and had grown during that time.
  • There was no destruction of the bone.
  • In the biopsy, the tumor cells stained strongly positive for calretinin, a mesothelial marker.
  • Based on the tissue findings and the staining, the final diagnosis was metastatic mesothelioma.
  • The patient died 45 days later, after his medical condition worsened.
• The authors' conclusion: The authors stated that, to their knowledge, this was the first reported case of pleural mesothelioma metastasizing to the retromolar trigone. They concluded that new growing lesions in patients with a history of mesothelioma should be biopsied, and that such lesions must be distinguished from other oral cancers because the management is totally different.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Metastasis, Mesothelioma, Prognosis, Pleural Mesothelioma, Biopsy, Differential Diagnosis.

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