From Volume 48, Issue 10, November 2021 | Pages 846-848
This case report describes the rare presentation of lung carcinoma as bilateral masses affecting the mandibular gingivae. Although metastatic disease to the mouth is rare, accounting for only 1% of oral malignancies, it is essential to ensure that the presence of cancer is included in any differential diagnosis.
Metastasis can have several forms of clinical presentation and, in this case, bilateral gingival masses posed a diagnostic dilemma. Bilateral gingival metastases are extremely rare which can often lead to erroneous diagnosis. All oral abnormalities persisting for longer than 3 weeks should be referred urgently for specialist assessment and need for biopsy.1 Metastatic dissemination to the oral cavity is rare and accounts for about 1% of oral malignancies.2 However, these malignancies are of great significance since, in 20% of patients, they may be the first indication of an asymptomatic primary tumour elsewhere in the body. The most frequently affected sites are the mandibular molar regions, followed by the gingivae.3 With respect to soft tissue disease, the most common site for metastasis is the attached gingiva (57%), followed by the tongue (27%), tonsil (8%), palate (4%), lip (3%), buccal mucosa (1%) and floor of mouth (<1%).3 The most frequent primary malignancies presenting as oral metastases are the lung, kidney, liver and prostate for men, and breast, genitalia, kidney and colo-rectum for women.2
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