Gingival exophytic lesions as first oral manifestation of primary lung adenocarcinomas: Systematic review

Metastases from malignant tumors in the oral cavity are rare and comprise approximately 1% of all oral neoplasms, being more frequent in the jaws than in the soft tissues. The presentation of a gingival metastasis as the first manifestation of a primary tumor in the oral cavity is extremely rare. The objective of this review is to update the diagnosis and management of oral metastasis being the first clinical manifestation of the tumor and review all the cases published to date, providing a new original clinical case with very specific histopathological characteristics. We systematically reviewed the literature in order to find all the cases of primary lung tumors that appeared with a gingival metastasis as the first manifestation. The search process involved a total of 1916 articles. After reading the latter, 15 (one of them with two different cases) met the inclusion criteria. Of the 15 articles, 6 were rated as medium quality (40%) and 9 as high quality (60%). We present a lung adenocarcinoma that first manifested as a metastasis in the gum, simulating a benign lesion. The unusually high growth rate of this lesion should conduct to have other diagnostic possibilities, and histopathological confirmation is essential.