Kajita Tomonari, Miyashita Hitoshi, Kitamura Jun, Kouketsu Atsumu, Kumamoto Hiroyuki, Takahashi Tetsu
Division of Oral and Maxillofacial Surgery, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan.
Division of Oral and Maxillofacial Surgery, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan.
Int J Surg Case Rep. 2022 Sep;98:107499. doi: 10.1016/j.ijscr.2022.107499. Epub 2022 Aug 11.
Pulmonary pleomorphic carcinoma (PPC) is a rare subtype of non-small cell lung cancer. No standard therapy has been established for advanced disease, which results in poor prognosis. Some cases of PPC metastasizing to mandibular gingiva have been reported, and the involved site in these reports is all unilateral mandible.
We report a case of PPC metastasizing to the anterior mandibular gingiva in a 68-year-old man. The patient was referred to our hospital with tumor bleeding and difficulty with intake. One month before, he had been diagnosed as PPC. The size of oral tumor was 28 × 25 mm, and we performed surgical resection. Although there was no recurrence of oral lesion, he died of systemic metastases after 3 months since the surgery.
The prognosis of patients with metastatic tumor in oral region is poor. Radical treatment for oral lesion is often difficult due to the existence of other metastasis or the refractory, in particular cases with high grade malignancies such as PPC. On the other hand, because of the development of cancer treatment and the arrival of super-aging society, the number of patients with metastatic tumor in oral region has been expected to increase in future.
PPC metastasizing to the gingiva of mandibular symphysis is extremely rare. If there are possibilities to improve the prognosis or quality of life, radical or palliative treatment for metastatic tumor in oral region should be performed.
肺多形性癌（PPC）是非小细胞肺癌的一种罕见亚型。对于晚期疾病尚未确立标准治疗方法，这导致预后不良。已有一些PPC转移至下颌牙龈的病例报道，且这些报道中的受累部位均为单侧下颌骨。
我们报告一例68岁男性PPC转移至下颌前部牙龈的病例。该患者因肿瘤出血和进食困难被转诊至我院。一个月前，他被诊断为PPC。口腔肿瘤大小为28×25mm，我们进行了手术切除。尽管口腔病变未复发，但术后3个月他死于全身转移。
口腔区域有转移瘤的患者预后较差。由于存在其他转移或难治性情况，尤其是像PPC这种高级别恶性肿瘤的病例，对口腔病变进行根治性治疗往往很困难。另一方面，由于癌症治疗的发展和超老龄化社会的到来，预计未来口腔区域有转移瘤的患者数量将会增加。
PPC转移至下颌联合牙龈极为罕见。如果有可能改善预后或生活质量，应针对口腔区域的转移瘤进行根治性或姑息性治疗。
