Histopathological Analysis of Metastatic Tumours of the Oral Cavity with Example of Metastatic Renal Cell Carcinoma to Tongue

Ljiljana Vučković 1 , Mirjana Miladinović 1 , Vladimir Popović 2 , Nevenka Lukovac Janjić 3 , Milena Borilović 2  and Mirjana Đuričković 4
  • 1 Department of Pathology, Clinical Centre of Montenegro, Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
  • 2 Department for Maxillofacial Surgery, Clinical Centre of Montenegro, , Podgorica, Montenegro
  • 3 Clinic for Oncology and Radiotherapy, Clinical Centre of Montenegro, , Podgorica, Montenegro
  • 4 Faculty of Medicine, Dentistry program, University of Montenegro, Podgorica, Montenegro

Summary

Background/Aim: Metastatic tumours make up only 1-3% of all malignant tumours of the oral region; however, in 25% of the total number of cases, they are the first sign of the disease. Usually, metastases in the oral region are followed by poor prognosis. Metastases are more common in the mandible than in the maxilla; in soft tissues, they most commonly occur in the attached gingiva and tongue. Malignant tumours of the lung, breast, kidney, liver, bone, prostate, thyroid gland, skin, colon and female genital organs most commonly give metastases in this region, usually in patients aged 40 to 70 years.

Case Report: We present a patient aged 79 years with a tumour change in the body of the tongue. After histopathological and immunohistochemical analysis (Cytokeratin, Vimentin, CD 10 positive tumour cells, Cytokeratin 7, Cytokeratin 20 negative tumour cells), there was a suspicion of metastasis of clear cell renal carcinoma (CCRC). Due to renal cancer, the patient had left kidney operated seven years before the diagnosis of tongue tumour.

Conclusions: Diagnosis of metastatic tumours of the oral region is a great challenge, both for clinicians and for histopathologists. Since it is a heterogeneous group of neoplasms, standard histopathological tissue processing, is not always sufficient to determine the histological type of tumour and its primary origin. In the analysis of metastatic tumours of the oral region, team work is important and careful clinical and histopathological assessment lead to definitive and accurate diagnosis.

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