Abstract
A 67-year-old male was admitted to the Clinic of Oral and Maxillofacial Surgery II, Dental Hospital, Matsumoto Dental University, with a chief complaint of a painless swelling of the mandibular gingiva. Under a clinical diagnosis of an epulis of the gingiva, surgical excision was performed. The material was then diagnosed histopathologically as a poorly differentiated carcinoma. After reporting the biopsy results, we obtained important information that the patient had been tentatively diagnosed as having hepatocellular carcinoma by clinical examination. Therefore, the tumor was further examined immunohistochemically. The immunohistochemical examination used some useful markers for the diagnosis of hepatocellular carcinoma, i.e., CEA, EMA, α-1-ACT, α-1-AT, albumin, AFP, and CK 7, 8, 18, 19. The examination results were positive for many immunohistochemical profiles of hepatocellular carcinoma, although there was no so-called “hepatoid pattern” in the histopathological observation. Finally the gingival carcinoma was considered to be a poorly differentiated metastatic carcinoma that had originated from a “hepatocellular carcinoma”, as judged from our histopathological and immunohistochemical examinations. This was determined although the histopathological observation of the primary lesion in the liver was not carried out. No additional treatment was undertaken as according to the wishes of the family.
