Abstract
Metastases to orofacial tissues are infrequent, their incidence being 1%–8% of malignant oral tumors, sometimes manifesting as the first clinical sign of an occult cancer. Renal cell carcinoma (RCC) is the second most common metastatic carcinoma to the oro-facial tissues, involving the jawbones, gingiva, oral mucosa, tongue or salivary glands. Also, RCC frequently displays a prominent clear cell component, which may predominate in the clear cell renal cell carcinoma subtype (CCRCC) and histologically mimic many other clear cell tumors, both benign and malignant, which can be epithelial (from keratinizing epithelia, cutaneous adnexa, salivary glands and odontogenic epithelium), melanocytic or mesenchymal in origin. In view of the necessity for prompt and accurate diagnosis of such unusual neoplasms, we report on the salient clinico-pathological features of 7 CCRCC metastatic to the oro-facial tissues, and highlight their immunohistochemical profile, to more accurately discriminate this neoplasm from other tumors of the oral cavity with a prominent clear cell component.
Highlights
Metastatic tumors involving the oro-facial tissues are infrequent, their incidence ranging between 1% and 8% of all oral malignant tumors [1,2,3,4]
50% of the metastases were detected in the thyroid, nose and paranasal sinuses, and pharynx [11,13,20], at variance with solitary metastases to the head and neck, which are exceedingly rare, accounting for only 1% of the cases [2,11,19,20]
Renal cell tumors show different morphology according to their histotype so that, quite often, an immunohistochemical evaluation is deemed necessary for a correct histological diagnosis, and this is obviously more evident in the case of metastases
Summary
Metastatic tumors involving the oro-facial tissues are infrequent, their incidence ranging between 1% and 8% of all oral malignant tumors [1,2,3,4]. The predilection of metastatic neoplasms for specific sites in the oro-facial region may be influenced by peculiar clinical conditions, such as the gingival-parodontal soft tissues of dentates with inflammatory lesions of the parodontum, or the same tissues in edentulous individuals bearing prostheses. In such instances, the re-organization of the local blood flow, following inflammation or induced by the pressure of the prosthesis, have been postulated to facilitate the metastatic growth [10]
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