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گزارش یک مورد متاستاز از کارسینومای کلیوی سلول روشن به لثه قدام فک بالا در یک مرد 75 ساله

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E-mail: saghravaniann@mums.ac.ir

Metastasis of Clear Cell Renal Cell Carcinoma to the Maxillary Gingiva in a 75-Year Old Man: A Case Report

Nasrollah Saghravanian*#, AliReza Rajaei**, Nazanin Bashardoust**

*Assistant Professor, Dept of Oral and Maxillofacial Pathology, Dental School, Mashhad University of Medical Sciences, Mashhad, Iran.

**Postgraduate Student, Dept of Oral and Maxillofacial Pathology, Dental School, Mashhad University of Medical Sciences, Mashhad, Iran.

Received: 4 April 2010; Accepted: 26 May 2010

Introduction: About 1% of all oral cancers are metastases of primary tumors elsewhere in the body and could be located in the soft tissue as well as in the jaw bones. Among all the primary tumors that arise below the level of the clavicle, renal cell carcinoma (RCC) is the third most common neoplasm according to metastasis in the head and neck region. Majority of the reported cases involve the jawbones rather than the soft tissues. Here one case of metastatic RCC to the maxillary gingival is reported.

Result: The Patient was a 75 year-old man who chiefly complained about swelling in his anterior region of the maxillary gingiva. Excisional Biopsy was performed. Metastatic clear cell Renal cell carcinoma (CCRCC) was diagnosed by microscopic examination by demonstrating islands of cells separated from each other by thin fibrovascular septa, with stroma containing numerous sinusoid like vessels and immunohistochemistry (IHC) Staining (S-100, vimentin, EMA, CEA, CD10, CK7,TTF-1 and PSA). CT scan confirmed tumor in the right kidney. Nephrectomy and chemotherapy were performed but patient died 9 months after treatment as a result of metastases to brain and lung.

Conclusion: CCRCC arise from renal tubular epithelium. Microscopically differential diagnosis for jaw tumors with clear cells includes a broad spectrum of tumors such as odontogenic tumors, salivary gland tumors and metastatic tumors. Generally, an immunohistochemistry panel consisting of S-100, vimentin, EMA.CEA, CD10.CK7, TTF-1 and PSA is useful to diagnose CCRCC from other clear cell tumors. Although IHC aids us in diagnosis, other paraclinical procedures like imaging should be done, to confirm the diagnosis.

Key words: Metastatic tumor, oral cavity, renal cell carcinoma, clear cell, immunohistochemistry. #

##

# Corresponding Author: saghravaniann@mums.ac.ir

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decrease as compared to Ti, reaching an ~80% reduction when a longer spacer was used (Ch_AHA_Nt-Dhvar5 and Ch_GG_Nt- Dhvar5) (p &lt; 0.05). These two Dhvar-bearing surfaces did

Although development of a second primary tumor is frequent among patients with squamous cell carcinoma of the upper aerodigestive pathways, most are metachronous tumors, w hereas in

Unlike the increase in leaf area, the number of in fl orescences produced by the plants declined during some months (Figure 1), but it would be necessary to analyze production

The probability of attending school four our group of interest in this region increased by 6.5 percentage points after the expansion of the Bolsa Família program in 2007 and

Diante do exposto, o presente estudo mostra-se relevante no campo da saúde pública no sentido de reforçar os achados disponíveis, ampliar as evidências sobre a relação