Metastasis of mesothelioma to the maxillary gingiva

Our plain-English summary of Metastasis of mesothelioma to the maxillary gingiva, by Y. Ohnishi, M. Sugitatsu, M. Watanabe, et al (Oncology Letters, 2014).

The study

• Authors: Y. Ohnishi, M. Sugitatsu, M. Watanabe, T. Fujii, K. Kakudo
• Journal: Oncology Letters
• Published: 2014;8(3):1214-1216
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Malignant mesothelioma predominantly arises from the serosal surfaces of the pleural or peritoneal cavity. There is currently no effective standard treatment for mesothelioma and the prognosis for patients is poor; the majority of patients with malignant mesothelioma succumb between 12 and 17 months following diagnosis. The association of all forms of malignant mesothelioma with asbestos exposure has been well documented. However, metastasis to the oral gingiva is rare, as only four cases have previously been reported; two cases of metastasis to the tongue and four cases to the jaw bone. In the current report, the case of a 62-year-old male with metastatic mesothelioma is presented. To the best of our knowledge, this is the first report regarding the metastasis of this type of neoplasm to the maxillary gingiva.

In plain English

This was a case report of one patient treated in Osaka, Japan. A 62-year-old man was referred in November 1996 with two months of worsening shortness of breath. He had fluid around the left lung and a mass in the left lung field, and a pleural biopsy showed diffuse mesothelioma. The authors described him as an industrial employee with about 24 years of asbestos exposure; they did not say which asbestos fiber type he had been exposed to. He began radiotherapy (total dose 40 Gy). Two months after he first presented, he had a large, painless mass on the upper gum (maxillary gingiva) around the molar teeth. A biopsy of this mass showed mixed-type diffuse mesothelioma that matched the earlier pleural biopsy. Because the tumour grew quickly and he could not eat, it was removed to improve his quality of life. He died 35 days later. The authors believed this was the first report of mesothelioma spreading to the maxillary gingiva. They concluded that treatment aimed at his mouth was effective because it let him keep eating until shortly before death.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One 62-year-old man referred to Osaka Red Cross Hospital, Osaka, Japan, in November 1996
• Exposure: Industrial employee with about 24 years of asbestos exposure. The fiber type involved in this patient's exposure was not specified, and no specific job or product was named. The background discussion mentions amphibole fibres only in general terms.
• Main results:
  • A pleural biopsy showed diffuse mesothelioma, following a left-sided pleural effusion and a mass in the left lung field.
  • The patient began radiotherapy, with a total dose of 40 Gy.
  • Two months after initial presentation, the patient had a large, painless mass on the maxillary gingiva around the molar teeth. The mass had been growing for two weeks.
  • A biopsy of the gingival mass showed mixed-type diffuse mesothelioma.
  • The gingival biopsy looked identical to the earlier pleural biopsy.
  • Immunostaining showed strong positivity for vimentin, focal positivity for cytokeratin, and negative reactions for carcinoembryonic antigen and epithelial membrane antigen.
  • The rapidly growing gingival tumour, which prevented eating, was removed to improve quality of life. The removed mass measured 30x25x20 mm.
  • Surgery on the primary site was abandoned because of the possibility of metastases.
  • The patient died 35 days after the gingival surgery.
  • The authors stated that, to their knowledge, this was the first report of mesothelioma metastasis to the maxillary gingiva.
• The authors' conclusion: The authors concluded that treatment chosen to improve the patient's oral condition and quality of life was effective, because it let him continue to eat until just before he died.

Topics

Medical terms in this study, explained in our Lexicon: Metastasis, Mesothelioma, Malignant Mesothelioma, Serosal Surface, Peritoneal Cavity, Prognosis, Asbestos Exposure, Neoplasm.

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