Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2005 Sep 19:5:117.
doi: 10.1186/1471-2407-5-117.

Oral ulcer as an exclusive sign of gastric cancer: report of a rare case

Piergiuseppe Colombo  1 , Luca Tondulli, Giovanna Masci, Andrea Muzza, Lorenza Rimassa, Duccio Petrella, Armando Santoro
Affiliations
Case Reports

Oral ulcer as an exclusive sign of gastric cancer: report of a rare case

Piergiuseppe Colombo et al. BMC Cancer. .

Abstract

Background: The oral cavity is a rare but occasional target for metastases, which may masquerade as various benign and inflammatory lesions, and sometimes also be asymptomatic. Oral metastatic lesions have been described in various cancers, particularly lung, breast and kidney carcinoma.

Case presentation: We here describe an uncommon case of a hard palate mucosa and gingival metastasis from gastric carcinoma that was originally diagnosed as a periodontal disease. Histopathological examination of a biopsy of the lesion revealed a signet-ring cell carcinoma, and a subsequent biopsy of an ulcerated stomach lesion showed a poorly differentiated gastric carcinoma. The patient underwent gastric resection but died of heart failure on the tenth postoperative day; a post-mortem examination revealed a residual bilateral ovarian infiltration by gastric carcinoma (Krukenberg's tumor).

Conclusion: An occult carcinoma of the stomach may rarely metastasise to the oral cavity even as a first and exclusive manifestation; it is important to bear this possibility in mind because such conditions may mimic a benign disease.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Histopathological findings on hard palate biopsy showing diffuse chorion infiltration by a poorly differentiated carcinoma with a focal microglandular growth pattern (hematoxylin and eosin stain, ×400).
Figure 2
Figure 2
Gastric biopsies revealed an undifferentiated signet-ring cell gastric carcinoma (hematoxylin and eosin stain, ×400). Note the characteristic distribution of blue intracytoplasmic mucines in the neoplastic cells (inset) (Alcian-Pas stain, ×400).
Figure 3
Figure 3
Clinical photograph of the hard palate lesion after biopsy.
Figure 4
Figure 4
Magnetic resonance image of the maxilla showing an enhanced lesion of the left hard palate with thickening of the genal mucosa and no bone involvement.
See this image and copyright information in PMC

References

    1. Devesa SS, Blot WJ, Fraumeni JF., Jr Changing patterns in the incidence of esophageal and gastric carcinoma in the United States. Cancer. 1998;83:2049–53. doi: 10.1002/(SICI)1097-0142(19981115)83:10<2049::AID-CNCR1>3.0.CO;2-2. - DOI - PubMed
    1. Noguchi Y, Yoshikawa T, Tsuburaya A, Motohashi H, Karpeh MS, Brennan MF. Is gastric carcinoma different between Japan and the United States? Cancer. 2000;11:2237–46. doi: 10.1002/1097-0142(20001201)89:11<2237::AID-CNCR12>3.0.CO;2-9. - DOI - PubMed
    1. Imachi M, Tsukamoto N, Amagase H, Shigematsu T, Amada S, Nakano H. Metastatic adenocarcinoma to the uterine cervix from gastric cancer. A clinicopathologic analysis of 16 cases. Cancer. 1993;71:3472–77. - PubMed
    1. Lund BA, Moertel CG, Gibilisco JA. Metastasis of gastric adenocarcinoma to oral mucosa. Oral Surg Oral Med Oral Pathol. 1968;25:805–809. doi: 10.1016/0030-4220(68)90151-5. - DOI - PubMed
    1. Astacio JN, Alfaro C. Oral mucosa metastasis from gastric adenocarcinoma. Oral Surg Oral Med Oral Path. 1969;28:859–61. doi: 10.1016/0030-4220(69)90339-9. - DOI - PubMed

Publication types