A case report of metastasis of malignant mesothelioma to the oral gingiva

Our plain-English summary of A case report of metastasis of malignant mesothelioma to the oral gingiva, by S. Moser, M. Beer, G. Damerau, et al (Head & Neck Oncology, 2011).

The study

• Authors: S. Moser, M. Beer, G. Damerau, H.T. Lübbers, K.W. Grätz, A.L. Kruse
• Journal: Head & Neck Oncology
• Published: 2011;3:21
• Type of article: Case report
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Introduction: Metastatic mesothelioma to the oral cavity arises from the pleura or peritoneum and distant hematogenous metastases are seen in more than half of cases but only a few cases are reported to the oral cavity.

Case: A 75 year old male suffering from metastatic mesothelioma presents an hyperplasia of the attached gingiva. Malignant mesothelioma is a rare tumour arising from pleura, pericardium or peritoneum.

Conclusion: This article highlights the importance of biopsy and histopathological diagnosis of oral lesions especially in case of a malignant history.

In plain English

This was a case report from the University Hospital Zurich. It described a 75-year-old man, a non-smoker, who had had significant asbestos exposure during his working life as an electrician. Epitheloid mesothelioma had been diagnosed two years earlier and treated with chemotherapy (pemetrexed, given with palliative intent). The patient's dentist referred the patient with a painless growth on the attached gingiva (gum) beside a lower premolar tooth. It had been present for 6 weeks, had been growing, and measured about 1.5 cm by 1.0 cm. Imaging showed no destruction of the jawbone. A biopsy, examined with microscopy and immunohistochemical staining, confirmed a metastasis of the pleural mesothelioma. Reviewing the English literature, the authors found 12 such oral cases, including this one, all in men: six on the tongue, four on the attached gingiva, one in bone and one in the floor of the mouth. Surgery was avoided because of reduced life expectancy. The authors concluded that the case highlighted the importance of biopsy and histopathological diagnosis of oral lesions, especially in patients with a history of malignancy.

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 with a brief review of previously published cases
• Who was studied: one 75-year-old man referred to the Department of Oral Surgery, University of Zurich; previously diagnosed epitheloid mesothelioma; non-smoker
• Exposure: significant occupational asbestos exposure as an electrician; fiber type not stated
• Main results:
  • The patient's epitheloid mesothelioma had been diagnosed 2 years before the oral lesion and treated with chemotherapy
  • The gum lesion around tooth 35 measured about 1.5 cm by 1.0 cm
  • Imaging of the lower jaw showed no bone destruction
  • Histology and immunohistochemistry confirmed the lesion was a metastasis of the pleural mesothelioma
  • Tumour cells were strongly positive for calretinin, a mesothelial marker
  • Positive cytokeratin 5/6 and negative Ber-EP4 staining helped distinguish the tumour from adenocarcinoma
  • Literature review: 12 oral metastasis cases in all, including this one
  • Of the reviewed cases, six were on the tongue, four (including this one) on the attached gingiva, one in bone and one in the floor of the mouth
  • The authors reported a median age of 61.25 years among the reviewed cases
  • After consulting the oncologist, the treating team limited therapy to regular recalls and changed chemotherapy drugs, avoiding surgery because of reduced life expectancy
• The authors' conclusion: The authors concluded that the case highlights the importance of biopsy and histopathological diagnosis of oral lesions, especially in patients with a history of malignancy.

Topics

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

Medical terms in this study, explained in our Lexicon: Metastasis, Mesothelioma, Pleura, Peritoneum, Pericardium, Biopsy.

Related studies

• Gingival metastasis as first sign of multiorgan dissemination of epithelioid malignant mesothelioma — A. Billè, M. Platania, et al. (2014)
• Metastasis of mesothelioma to the maxillary gingiva — Y. Ohnishi, M. Sugitatsu, et al. (2014)
• A case report of metastasis of malignant mesothelioma to the retromolar trigone — A. Arslan, C. Ozcakir-Tomruk, et al. (2016)
• Expression of calretinin, thrombomodulin, keratin 5, and mesothelin in lung carcinomas of different types: an immunohistochemical analysis of 596 tumors in comparison with epithelioid mesotheliomas of the pleura — M. Miettinen, M. Sarlomo-Rikala (2003)
• Value of mesothelial and epithelial antibodies in distinguishing diffuse peritoneal mesothelioma in females from serous papillary carcinoma of the ovary and peritoneum — R.L. Attanoos, R. Webb, et al. (2002)
• The calcium binding protein calretinin is a selective marker for malignant pleural mesotheliomas of the epithelial type — V. Gotzos, P. Vogt, et al. (1996)

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