A case of renal cell carcinoma in which long-term survival was obtained by simultaneous surgical resection of the primary tumor and maxillary gingival metastasis

Abstract

Paranasal sinuses and the mandible are the most common sites of metastasis from renal cell carcinoma in the oral and maxillofacial region. Renal cell carcinoma with maxillary gingival metastasis is rare. We report a case of renal cell carcinoma diagnosed after discovery of a maxillary gingival swelling. The patient was a 77-year-old man who presented to our department with swelling of the left maxillary gingiva. An exophytic mass measuring 41 × 31 mm was found in the maxillary gingiva between the left central incisor and the left first premolar. Based on the results of a biopsy and imaging examinations, metastasis of a renal cell carcinoma to the maxillary gingiva was diagnosed. Because an abdominal aortic aneurysm was detected on the computed tomographic scan, coil embolization and stent-graft insertion were performed. Meanwhile, the intraoral tumor rapidly increased in size. A left nephrectomy and maxillary partial resection were performed with the patient under general anesthesia. Renal cell carcinoma with metastasis has a poor prognosis; however, long-term survival of 7 years since the initial surgery was obtained. The patient has metastasis to the left ilium, but recurrence of the primary lesion and the intraoral metastasis has not occurred.