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Review
. 2021 Mar;49(3):300060521997592.
doi: 10.1177/0300060521997592.

Rare submandibular gland metastasis of hepatocellular carcinoma: case report and review of the literature

Sinan Deng  1 , Danping Ruan  1 , Jie He  2
Affiliations
Review

Rare submandibular gland metastasis of hepatocellular carcinoma: case report and review of the literature

Sinan Deng et al. J Int Med Res. 2021 Mar.

Abstract

Hepatocellular carcinoma (HCC), the most common primary hepatic tumor, metastasizes in more than 50% of cases. However, metastasis of HCC to the submandibular glands is very rare. HCC rarely metastasizes to the salivary glands; only six cases of metastasis to the parotid gland have been reported in the English-language literature. Moreover, only one case of metastasis of HCC to the submandibular glands has been reported to date, and the affected patient died of hepatic failure. This clinical report describes a 55-year-old man who had undergone two surgeries for liver cancer and subsequently presented with a 2-week history of a right submandibular mass. We performed dissection of the right submandibular triangle, and metastatic HCC of the submandibular gland was diagnosed. Although HCC metastases to the oral cavity have been reported, this is only the second case of HCC metastasis to the submandibular gland. Fine-needle aspiration biopsy is recognized as a simple, direct approach for morphologic diagnosis of salivary gland lesions; however, histological and immunohistochemical examination of the surgical specimen remains necessary.

Keywords: Hepatocellular carcinoma; case report; hepatic failure; histopathology; metastasis; submandibular gland.

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Conflict of interest statement

Declaration of conflicting interest: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Hepatocellular carcinoma was seen in the right lobe of the liver on abdominal computed tomography. The mass showed obvious heterogeneous enhancement in the arterial phase and a typical wash-out pattern in the portal and delayed phases. (a) Arterial phase. (b) Portal phase. (c) Delayed phase. R, right; L, left.
Figure 2.
Figure 2.
Computed tomography showed a 20-mm round and well-defined enhancing nodular lesion under the right jaw (arrows) with no other remarkable lymph node enlargement.
Figure 3.
Figure 3.
Resection of the 20-mm tumor and right submandibular gland.
Figure 4.
Figure 4.
Photomicrograph of the oral mass exhibiting nuclear anaplasia and pleomorphism (hematoxylin and eosin, ×100).
See this image and copyright information in PMC

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