Gastric adenocarcinoma metastases to the alveolar mucosa of the mandible: a case report and review of the literature

Abstract

Malignant tumours rarely metastasize to the oral cavity. When they do, such metastases may arise from various locations including the lung, breast, kidney, prostate and colon. Soft tissue oral metastasis from gastric adenocarcinoma is extremely rare, and limited information exists regarding the presentation and work-up of metastatic gastric carcinoma into the oral soft tissue. We present an unusual case of a 70-year-old man and review the records of 17 cases of soft tissue oral metastasis from gastric carcinoma in the English and Japanese literature. Metastatic lesions from all sources are typically diagnosed in patients in their fifth to seventh decade, with the most common sites of soft tissue metastasis being the gingiva and alveolar mucosa of the mandible. In almost one quarter of patients a metastatic lesion in the oral cavity is the first manifestation of an undiscovered primary malignancy. They grow rapidly and tend to bleed and ulcerate. Because of their rarity and clinical characteristics, gastric metastatic tumours in the oral cavity are challenging to diagnose. Inflammatory and reactive lesions are common in the oral cavity and they should be considered in the differential diagnosis. Careful examination with a high degree of clinical suspicion, as well as a multidisciplinary approach is suggested.