Ðanić Petar, Ðanić Davorin, Macan Darko
Department of Oral and Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia.
Department of ENT, Head and Neck Surgery, "Dr Josip Benčević" General Hospital, Slavonski Brod, Medical School Osijek, University Josip Juraj Strossmayer, Osijek; Croatia.
Med Glas (Zenica). 2018 Feb 1;15(1):52-58. doi: 10.17392/932-18.
Aim Distal metastases to oral cavity are very rare. Adenocarcinoma, renal cell carcinoma (RCC) and squamous cell carcinoma are the most common metastatic tumours. The aim of this study was to assess the diagnostic relevance of metastatic renal cell carcinoma on tongue manifestations in large patient series. Methods A patient with distal RCC metastases to the tongue and neck lymph nodes as the first manifestations of malignancy was presented. Also, all reports described during 106-year period relating to distal RCC metastasis to the tongue were evaluated. Results In the presented patient, initial presentation of RCC was metastasis to the tongue. Three months after nephrectomy, tongue tumour resection and radical neck dissection were performed. Histopathological analysis confirmed RCC metastasis. Postoperatively, the patient underwent radiotherapy and polychemotherapy. Tongue metastasis from RCC is extremely rare with only 51 cases reported during the 106-year period. In only 7 patients tongue metastasis was reported as an initial presentation of RCC. Conclusion The RCC metastasizing to the tongue is extremely rare and thus it poses a diagnostic challenge especially when it is the first sign of malignancy. Therapeutic decisions should maximize patient comfort and minimize morbidity considering the poor long-term prognosis.
目的 口腔远处转移极为罕见。腺癌、肾细胞癌(RCC)和鳞状细胞癌是最常见的转移瘤。本研究的目的是在大量患者系列中评估转移性肾细胞癌对舌部表现的诊断相关性。方法 报告了1例以舌部和颈部淋巴结远处RCC转移为恶性肿瘤首发表现的患者。此外,还评估了106年间所有关于RCC远处转移至舌部的报告。结果 在该例患者中,RCC的最初表现为转移至舌部。肾切除术后3个月,进行了舌部肿瘤切除和根治性颈清扫术。组织病理学分析证实为RCC转移。术后,患者接受了放疗和多药化疗。RCC舌部转移极为罕见,106年间仅报告了51例。仅7例患者的舌部转移被报告为RCC的首发表现。结论 RCC转移至舌部极为罕见,因此尤其当它是恶性肿瘤的首个征象时,会带来诊断挑战。考虑到长期预后较差,治疗决策应使患者舒适度最大化并使发病率最小化。