Abstract
A case of metastatic sarcomatoid renal cell carcinoma to the mandible treated with Sorafenib is reported. A 76-year-old man consulted us for hyposthesia of the right lower lip. Panorama X-ray film showed a ra-diolucent lesion in the right mandibular body. A diagnosis of metastatic tumor to the mandible from the left kidney was made after evaluation by computed tomography and positron emission tomography, which also revealed multiple bone metastases. After radiotherapy for mandibular and thoracic lesions, nephrectomy was performed. Histological diagnosis was sarcomatoid renal cell carcinoma. Interferon therapy was performed but was not effective; therefore, a molecular targeted drug, Sorafenib, was administered. Sorafenib effectively inhibited the growth of oral and other metastatic lesions for 10 months. Quality of life was relatively well maintained with tolerable adverse effects. The patient survived for as long as 2 years after appearance of the first symptom.
Highlights
Metastatic tumors to the oral cavity are very uncommon and represent approximately 1% of oral neoplasms [1]
We reported a case of metastatic sarcomatoid renal cell carcinoma to the mandible, which was treated with Sorafenib in addition to nephrectomy, radiotherapy, and interferon therapy
Hypothyroidism was controlled with Levothyroxine. To reduce these side effects, Sorafenib was replaced with Sunitinib; the patient died of cancerous cachexia 2 years after developing hyposthesia of the lower lip
Summary
A 76-year-old man consulted a dental clinic with a complaint of hyposthesia of the right lower lip. He had noticed the hyposthesia 2 months previously; the symptom did not improve. He was referred to our hospital for a complete medical examination in September, 2008. He had a history of hypertension and had been using tobacco and alcohol for 50 years. His face was symmetric and the skin and oral mucosa in the right buccal region were normal (Figure 1).
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