Lung Adenocarcinoma with Gingival Metastasis

Gingival metastasis of lung cancer is uncommon. We report the case of an 82-year-old male smoker admitted to the pulmonology department with right pleural effusion. A chest computed tomography (CT) scan showed an invasive right hilar tumour, adherent to the superior vena cava, pulmonary artery, main right bronchus, mediastinal pleura and pericardium with lymphangitic carcinomatosis of the right lung. Pleural biopsy revealed pleural metastasis of pulmonary adenocarcinoma, its primary lung origin being confirmed by immunohistochemistry. One month later, the patient developed an ulcerated polypoid gingival mass. Biopsy of this lesion showed a poorly differentiated carcinoma compatible with metastasis from the lung adenocarcinoma. The patient underwent irradiation of the gingival mass at a dose of 30 Gray, but his condition worsened rapidly and he was not fit for chemotherapy. He received palliative treatment and died 2 months after diagnosis of his metastatic lung cancer. LEARNING POINTS: Lung cancers mostly metastasize to the bones, liver, lymph nodes, brain, lung and adrenal glands, with adenocarcinoma being the most common histological type. Distant metastasis to the oral region is very uncommon but can be the first manifestation of a primary tumour. Oral metastasis can be mistaken for a benign lesion, so a biopsy should be taken for further analysis.