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Gingival Metastasis from Gallbladder Cancer

Source: www.cgmh.org.tw
Topic: Gallbladder
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Sort Desciption: Gallbladder cancer is generally diagnosed at an advanced stage. The liver is the most commonly invaded organ by direct extension and/or metastasis, followed by regional lymph nodes. ...

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Gallbladder cancer is generally diagnosed at an advanced stage. The liver is the most commonly invaded organ by direct extension and/or metastasis, followed by regional lymph nodes. Oral soft tissue metastasis is extremely unusual. This report describes the case of a 62-year-old woman diagnosed with advanced metastatic gallbladder cancer, who initially presented with abdominal pain. Diagnosis of gallbladder cancer was made about 3 months after her symptoms developed, when a laparoscopic cholecystectomy was performed because of the suspicion of gallstones. Liver metastasis was also discovered during surgery. A postoperative investigation revealed additional lung and bone metastases. A visible left gingival tumor was found on physical examination and was confirmed as gallbladder cancer metastasis by compatible histopathology 1 month after surgery. The patient responded poor- ly to chemotherapy and unfortunately died 5 months after the diagnosis. The clinical pre- sentation of gallbladder cancer was relatively typical, apart from the unusual gingival metas- tasis. The medical literature contains quite a few examples of metastatic lesions located strictly in the oral soft tissue, however no case of gallbladder cancer metastasizing to the oral soft tissue has been previously reported. (Chang Gung Med J 2002;25:553-6)

Gallbladder cancer is an uncommon, but highly malignant tumor with a very low 5-year survival rate. Approximately 1/3 of all patients have wide- spread metastatic disease at the time of diagnosis, with the liver being the most common site of inva- sion. (1,2) Almost all patients die within 5-6 months after surgery, except those with incidental histopatho- logical findings. (2) Metastatic tumors of the oral region are uncommon, (3-7) and most are located in the mandible. (4-7) This report demonstrates a case of gall- bladder cancer with multiple metastases, including the first-reported involvement of the gingiva.

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