2014 Volume 26 Issue 3 Pages 123-129
Metastatic tumors in the oral cavity are rare. Most of them occur in the mandibular bone, and thus, the metastasis of the tumor to the oral mucosa is very rare. We herein reported a case of metastatic renal cell carcinoma at the soft palate, which is extremely rare.
A 75-year-old man was referred to our clinic; the chief complaint was a mass at the soft palate. As for past medical history, the patient underwent left radical nephrectomy because of renal cell carcinoma with multiple metastases to the lung 33 months previously, followed by adjuvant immunotherapy. The physical examination revealed the elastic soft, smooth-surfaced, painless mass in the soft palate, measuring 13 × 10mm in size. The mass in the soft palate has a central part with iso-signal intensity and a periphery with high signal intensity with a relatively clear margin, on the T2-weighted MR image. The clinical diagnosis was a malignant tumor of the salivary gland in the soft palate.
Under general anesthesia, the lesion was securely removed surgically with a 7-8mm safety margin with the help of intraoperative rapid frozen diagnosis. The pathological examination of the resected specimen revealed the clear cell carcinoma of the soft palate similar to the previously resected renal cell carcinoma. Moreover, the immunohistochemical study with monoclonal antibody against CD10 and vimentin substantiated strong positivity in the tumor cells, which eventually played a key role in the differential diagnosis. Based on the pathological and the histochemical findings, the tumor in the soft palate was finally diagnosed with the metastatic renal cell carcinoma.
There was neither recurrence in the oral cavity nor growth of the pulmonary metastases for 25 months after the surgical resection of the palatal mass.
