CC BY 4.0 · Avicenna J Med 2024; 14(02): 075-109
DOI: 10.1055/s-0044-1782202
Review Article

Renal Cell Carcinoma Metastasizing to Oral Soft Tissues: Systematic Review

Harnisha Vipulkumar Prajapati
1   Bhavya Dental Clinic and Implant Centre, Palanpur, Gujarat, India
,
Ruchira Shreevats
2   Primadent Dental Centre, Bangalore, Karnataka, India
,
3   Department of Oral Pathology and Microbiology & Forensic Odontology, Yamuna Institute of Dental Sciences and Research, Yamunanagar, Haryana, India
,
Harman Sandhu
4   Building Smiles Dental Clinic, Mohali, Punjab, India
,
5   Dentistry in Motion, North York, Ontario, Canada
,
Jasmine Kaur
6   St. Joseph Healthcare Centre, Toronto, Canada
› Author Affiliations
Funding None.
 

Abstract

Background Renal cancer metastasis to oral region is very rare. Studies have been published analyzing the cases of metastatic tumors to the oral cavity by many researchers. Very few research studies have been conducted till date to analyze the renal cancer metastasis as the sole primary source to the oral soft tissues. The goal of this study was to examine the published cases of oral soft tissue metastasis from renal cell carcinoma as the only primary source from 1911 to 2022.

Materials and Methods An electronic search of the published literature was performed without publication year limitation in PubMed/Medline, Scopus, Google Scholar, Web of Science, Science Direct, Embase, and Research Gate databases, using mesh keywords like (“Renal cancer,” or “Renal carcinoma” or “Renal cell cancer” or “Renal cell carcinoma”), and (“Metastasis” or “Metastases”), and (“Oral soft tissues” or “Tongue” or “Palate” or “Tonsil” or “Buccal mucosa” or “Salivary glands”). We also searched related journals manually and the reference lists.

Results Our research revealed a total of 226 relevant articles with 250 patients. Parotid glands and tongue were the most common sites of metastasis. 23% patients died with a survival time of 10 days to 4 years.

Conclusions Oral soft tissue metastasis from renal cell carcinoma has a bad prognosis. More cases need to be published in order to raise awareness of these lesions.


#

Introduction

According to GLOBOCAN databases, renal cell carcinoma (RCC) is one of the lethal neoplasms leading to approximately 2% of global cancer diagnoses and deaths, projecting to increase in burden worldwide.[1] RCC is the most common primary renal neoplasm constituting about 80 to 85% of all renal malignancies. Renal cortex and pelvis are the most predominant sites. In the recent years, the incidence of RCC has increased worldwide owing to the development of newer imaging aids. In most of the cases, RCC is diagnosed as an incidental finding during radiological investigations. Only in 10% of patients, “classic triad” of symptoms (i.e., hematuria, flank pain, and palpable masses) has been noticed.[2] One of the unique features of RCC is its long-term asymptomatic clinical behavior and high risk of distant organ metastasis in the advanced stages. Studies have reported that approximately 18% of patients with RCC have metastasis at the time of diagnosis, and in more than 50% of cases, metastasis is detected during the follow-up period after nephrectomy.[3] The most common organs involved in distant metastasis of RCC are lungs (45%), followed by bones (30%), lymph nodes (22%), liver (20%), adrenal glands (9%), and brain (9%).[4] Metastasis from RCC to oral cavity is very rare—tongue, gingiva, and mandible being the most affected sites.[5] The prognosis of metastatic lesions in the oral cavity is unfavorable because of their late detection owing to resemblance of benign growths. Literature has reported several studies analyzing the metastatic tumors to the oral region.[6] [7] [8] But a very few research work has been published till date to analyze solely the RCC metastasis to the oral soft tissues (OSTs). Thus, this review was conducted to examine the published cases of OST metastasis (OSTM) from RCC as the sole primary source in the literature from 1911 to 2022, and to learn about their characteristics.


#

Materials and Methods

The current research was carried out following the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Owing to the nature of the current review, any ethical approval was not required.

Focused Question

To conduct the study, CoCoPop (context, condition, population) framework, designed by Joanna Briggs Institute, was used focusing on the research question “how many cases of RCC metastasizing to OST have been documented in the literature, and what is the prognosis of these metastatic lesions.”

  • Pop (population): Patients with RCC.

  • Co (condition): Salivary gland metastasis.

  • Co (context): Characteristics of these patients.


#

Search Strategy for Identification of Studies

An electronic search of the published literature was performed without publication year limitation in PubMed/Medline, Scopus, Google Scholar, Web of Science, Science Direct, Embase, and Research Gate databases, using mesh keywords such as “Renal cancer” or “Renal carcinoma” or “Renal cell cancer” or “Renal cell carcinoma” and “Metastasis” or “Metastases,” and “Oral soft tissues” or “Tongue” or “Palate” or “Tonsil” or “Buccal mucosa” or “Salivary glands.” We also searched all related journals manually. The reference list of all articles was also checked ([Fig. 1]).

Zoom Image
Fig. 1 PRISMA flowchart showing search strategy.

#

Screening of Studies

The current review involved three steps of screening the studies. In the first step, titles were reviewed by two authors (H.V.P., R.S.) independently and duplicates were removed. Then the other two authors (S.G., H.S.) reviewed the selected abstracts of all the reports independently. The reviewers were calibrated on the basis of their assessment of their titles and abstracts of the first 50 references retrieved. The kappa value of agreement between reviewers was 0.82. If the title/abstracts met the eligibility rule, they were included in the study. In the final stage, the text of selected studies was screened by the remaining two authors (J.K., J.K.) separately. The full report was collected, discussed, and resolved for cases among all authors that appeared to fit the inclusion criteria or for which evidence was insufficient to make a clear determination.


#

Inclusion Criteria

  • Confirmed cases of OSTM from RCC as the sole primary source were included. Articles included were from 1911 to 2022.

  • Type of studies: Case reports, case series, retrospective analysis, clinicopathological studies, prospective studies, original researches, systematic reviews, and correspondence.

  • Cases were selected beyond the restriction of limitations on parameters such as age, gender, ethnicity, or socioeconomic status.

  • Articles published in any language were included.


#

Exclusion Criteria

  • Cases with no definite diagnosis of OSTM from RCC as the sole primary source.

  • Publications reporting the OSTM from any site other than kidney.

  • Cases with RCC metastasis to jaw bones were not included.

  • Studies which did not provide individual patient's data were excluded.

  • Review articles, editorials, conference abstracts, hypothesis articles, web news, media reports, animal studies.


#

Outcome Measures

Primary outcome measures: To evaluate the number of cases of RCC metastasizing to OST documented in the literature.

Secondary outcome measures: To evaluate other factors such as world-wide distribution of cases of OSTM from RCC, patient's demographic details, associated risk factors, predominant site of OSTM, clinical features of these metastatic lesions, most prevalent type of metastatic RCC, and type of therapies used.


#

Risk of Bias Assessment

Most of the studies included in this review were case reports and case series. Risk of bias was appraised following CARE and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklists.[9] [10] In several articles, there was missing information regarding many parameters used for data extraction. We tried reaching the authors of those cases to clarify this bias; however, we were unable to recover the missing information.


#

Data Extraction and Analysis

After study selection, screening, and a thorough examination, the data were extracted. The information gathered was cross-checked and tabulated into three tables ([Tables 1] [2] [3]). In case of missing data, 6 weeks' time was given to gather the information. If the information was still missing, we then indicated the missing data as “Not available (NA)” in the text and in the tables. The results were expressed in descriptive statistics. The overall survival rate was calculated by survival analysis with Kaplan–Meier curves.

Table 1

Details of publications included in the current review (1911–2022)

Sl. no.

Authors

Year

Country

Type of study

Total no. of patients

1.

Kostenko

1911

Russia

CR

1

2.

Coenen

1914

Germany

CR

1

3.

Branch and Norton

1928

USA

CR

1

4.

McNattin and Dean Jr

1931

USA

CR

1

5.

Trinca and Willis

1936

USA

CR

1

6.

Salman and Darlington

1944

USA

OR

1

7.

Scharg and Jordan

1945

USA

CR

1

8.

Bernier and Tiecke

1951

USA

CR

1

9.

Salman and Lengel

1954

USA

OR

1

10.

Persson and Wallenius

1961

Europe

CR

1

11.

Patey et al

1965

UK

CP

1

12.

Cranin et al

1966

USA

CR

1

13.

Del Carmen et al

1970

USA

CR

1

14.

Lansigan et al

1973

USA

CR

1

15.

Satomi et al

1974

Japan

CS

3

16.

Morri

1975

Japan

CR

1

17.

Batres et al

1978

USA

CR

1

18.

Friedlander and Singer

1978

USA

CR

1

19.

Nagayama and Oka

1979

Japan

CR

1

20.

Susan et al

1979

USA

CR

2

21.

Buchner and Begleiter

1980

Israel

CR

1

22.

Kucan et al

1981

USA

CS

1

23.

Bucin et al

1982

Europe

CR

1

24.

Fitzgerald et al

1982

USA

CR

1

25.

Nishimura et al

1982

Japan

SR

1

26.

Percival and Curt

1982

UK

CR

1

27.

Schaffner et al

1982

USA

CS

1

28.

Sist et al

1982

USA

CR

1

29.

Fay and Weir

1983

USA

CR

1

30.

Bedrosian et al

1984

USA

CR

1

31.

Lutcavage et al

1984

USA

CR

1

32.

Smits and Slootweg

1984

Netherland

CR

1

33.

Zohar et al

1985

Israel

CR

1

34.

Hessen et al

1986

USA

CS

1

35.

Kitao et al

1986

Japan

CR

1

36.

Harrison et al

1987

UK

CR

1

37.

Inai et al

1987

Japan

CR

1

38.

Kapoor et al

1987

India

CR

1

39.

Matsumoto et al

1987

Japan

CR

1

40.

Som et al

1987

USA

RA

1

41.

Tsianos et al

1987

Greece

CR

1

42.

Madison and Frierson

1988

USA

CR

1

43.

Gunbay et al

1989

Turkey

CR

1

44.

Hagen et al

1989

Germany

CR

1

45.

Melnick et al

1989

USA

CR

1

46.

Muller Mattheis et al

1989

Germany

CR

1

47.

Owens et al

1989

USA

CS

2

48.

Coppa and Oszczakiewicz

1990

USA

CS

2

49.

Martinez-Conde et al

1990

Spain

CR

1

50.

Ord et al

1990

UK

CR

2

51.

Pisani et al

1990

Italy

CR

1

52.

Tsuta et al

1990

Japan

CR

1

53.

Ishikawa et al

1991

Japan

CR

1

54.

Pastermoli

1991

Italy

CR

1

55.

Sarangi and Hameed

1991

UK

CR

1

56.

Okabe et al

1992

Japan

CR

1

57.

Ravi et al

1992

India

CR

1

58.

Shibayama et al

1993

Japan

CR

1

59.

Corsi et al

1994

Italy

CS

1

60.

Ziyada et al

1994

UK

CR

1

61.

Airoldi et al

1995

Italy

CR

1

62.

Borghi et al

1995

Italy

CR

1

63.

Stanley et al

1995

UK

CR

2

64.

Sykes et al

1995

UK

CR

1

65.

Aguirre et al

1996

USA

CR

1

66.

Ficcara et al

1996

Italy

CR

1

67.

Green et al

1997

UK

CR

1

68.

Konya et al

1997

Japan

CR

1

69.

Gangopadhyay et al

1998

Saudi Arabia

CR

1

70.

Garcia Lozano et al

1998

Spain

CR

1

71.

Tomita et al

1998

Japan

CR

1

72.

Vara et al

1998

Spain

CR

1

73.

Adil et al

1999

Turkey

CR

1

74.

Navarro et al

2000

Spain

CS

2

75.

Kundu et al

2001

UK

CR

1

76.

Li et al

2001

Germany

CR

1

77.

Fukuda et al

2002

Japan

RA

1

78.

Ieva et al

2002

Italy

CR

1

79.

Mekni et al

2002

Africa

CR

1

80.

Park et al

2002

USA

RA

1

81.

Pritychyk et al

2002

USA

RA

2

82.

Goel et al

2003

UK

CR

1

83.

Lang et al

2003

Ireland

CR

1

84.

Gogus et al

2004

Turkey

CR

1

85.

Jayasooriya et al

2004

Sri Lanka

CR

1

86.

Kyan et al

2004

Japan

CR

1

87.

Marioni et al

2004

Italy

CR

1

88.

Lim et al

2005

Australia

CR

1

89.

Seijas et al

2005

Spain

CR

1

90.

Tachi et al

2005

Japan

CR

1

91.

Cochrane et al

2006

UK

CR

1

92.

Huang et al

2006

Taiwan

CS

1

93.

Moudouni et al

2006

France

CR

1

94.

Pomar Blanco et al

2006

Spain

RA

1

95.

Porter et al

2006

UK

CR

1

96.

Stanczyk et al

2006

Poland

CR

1

97.

Stodulski et al

2006

Poland

CR

1

98.

Torres-Carranza et al

2006

Spain

CR

1

99.

Andreades et al

2007

Greece

CR

1

100.

del Rosario Regaldo et al

2007

USA

CR

1

101.

Kondo et al

2007

Japan

CR

2

102.

Newton et al

2007

UK

CR

1

103.

Tanaka et al

2007

Japan

CR

1

104.

Azam et al

2008

UK

CR

1

105.

Kalpan et al

2008

Turkey

CR

1

106.

Longo et al

2008

Italy

CR

1

107.

Mrena et al

2008

Finland

SR

3

108.

Narena-Matamala et al

2008

Chile

CR

1

109.

Spreafico et al

2008

Italy

CR

1

110.

Will et al

2008

USA

CR

1

111.

Basely et al

2009

France

CR

1

112.

Choi et al

2009

Japan

CR

1

113.

Dahlstrom

2009

Australia

CR

1

114.

Kella et al

2009

USA

CR

1

115.

Laco et al

2009

Czech Republic

CR

1

116.

Lee et al

2009

Japan

CR

1

117.

Maestre-Rodríguez et al

2009

Spain

CR

1

118.

Makos et al

2009

Greece

CR

1

119.

Massaccesi et al

2009

Italy

CR

1

120.

Novak et al

2009

Europe

CR

1

121.

Altinel et al

2010

Turkey

CR

1

122.

Miah et al

2010

UK

CR

1

123.

Ogunyemi et al

2010

USA

RA

1

124.

Saghravanian et al

2010

Iran

CR

1

125.

Syrolo et al

2010

Poland

CR

1

126.

Wayne et al

2010

USA

CR

1

127.

Zhang et al

2010

China

CR

1

128.

Eivazi Ziaei et al

2011

Iran

CR

1

129.

Ito et al

2011

Japan

CR

1

130.

Morvan et al

2011

France

CR

1

131.

Sinha et al

2011

India

CR

1

132.

Wadasadawala et al

2011

India

CR

1

133.

Yoshitomy et al

2011

Japan

CR

1

134.

Balliram et al

2012

Spain

CR

1

135.

Deeb et al

2012

USA

CR

1

136.

Ganini et al

2012

Italy

CR

1

137.

Ghazali et al

2012

UK

CR

1

138.

Gi-Julio et al

2012

Spain

CR

1

139.

Lau et al

2012

Australia

CR

1

140.

Lawlor et al

2012

USA

CR

1

141.

Novák et al

2012

Europe

CR

1

142.

Schwab and Lee

2012

USA

CR

1

143.

Serouya et al

2012

USA

CR

1

144.

Marcotullio et al

2013

Italy

CR

1

145.

Mazeron et al

2013

France

CR

1

146.

Ray et al

2013

India

Co

1

147.

Sikka et al

2013

India

Co

1

148.

Vegara et al

2013

Spain

CR

1

149.

Yanlan et al

2013

China

CR

1

150.

Abbaszadeh Bidokhty et al

2014

Iran

CR

1

151.

Akatiken et al

2014

Turkey

CR

1

152.

Hosan-Centenero et al

2014

Spain

CR

1

153.

Khobragade et al

2014

India

CR

1

154.

Kotak and Merrick

2014

UK

CR

1

155.

Kumar et al

2014

India

OR

1

156.

Kwak et al

2014

South Korea

CR

1

157.

Maralani et al

2014

Canada

CR

1

158.

Milner et al

2014

Poland

CR

1

159.

Suojanen et al

2014

Finland

CR

1

160.

Tunio et al

2014

Saudi Arabia

CR

1

161.

Udagar and Rungta

2014

USA

CR

1

162.

Altuntas et al

2015

Turkey

CR

1

163.

Bulguru et al

2015

Turkey

CR

1

164.

Jatti et al

2015

India

CR

1

165.

Kolokythas et al

2015

USA

CR

1

166.

Mellioni et al

2015

Italy

CR

1

167.

Piggati et al

2015

Brazil

CR

1

168.

Shi et al

2015

China

CR

1

169.

Ali et al

2016

Sudan

CR

1

170.

Balaban et al

2016

Turkey

CR

1

171.

Berkiten et al

2016

Turkey

CR

1

172.

Guimaraes et al

2016

Brazil

CR

1

173.

Hussain et al

2016

USA

CR

1

174.

Kudva et al

2016

India

CR

1

175.

Majewska et al

2016

Poland

CP

9

176.

Masaharu et al

2016

Japan

CR

1

177.

Renda et al

2016

Turkey

CR

1

178.

Selvi et al

2016

Turkey

CR

1

179.

Shirazian and Bahrami

2016

Iran

CR

1

180.

Wang et al

2016

Japan

CR

1

181.

Erkilic et al

2017

Turkey

CR

1

182.

Georgy et al

2017

India

CR

1

183.

Leider et al

2017

Germany

RA

2

184.

Nifosi et al

2017

Spain

CR

1

185.

Raiss et al

2017

Morocco

CR

1

186.

Rocca et al

2017

Italy

CR

1

187.

Danic et al

2018

Europe

CP

1

188.

Franzen et al

2018

Germany

CR

2

189.

Gandala et al

2018

India

CR

1

190.

Higuera et al

2018

Argentina

CR

1

191.

Khde et al

2018

USA

CR

1

192.

Kishore et al

2018

India

CR

1

193.

Morita et al

2018

Japan

CR

1

194.

Sahin et al

2018

Turkey

RA

1

195.

Vasilyeva et al

2018

USA

CR

1

196.

Abro et al

2019

USA

CR

1

197.

Boulanger et al

2019

France

CR

1

198.

Kilickap et al

2019

Turkey

CR

1

199.

Kizaekka et al

2019

UK

CR

1

200.

Nesbitt et al

2019

Australia

CR

1

201.

Netto et al

2019

Brazil

CR

1

202.

Sydney et al

2019

Turkey

CR

1

203.

Albsoul et al

2020

Jordan

CR

1

204.

Fejsa-Levakov et al

2020

Europe

CR

1

205.

Halnony et al

2020

Turkey

CR

1

206.

Kovalevsky et al

2020

Brazil

CR

1

207.

Nisi et al

2020

Italy

CR

2

208.

Patel et al

2020

USA

CR

1

209.

Stojanović et al

2020

Europe

CR

1

210.

Tsitsika et al

2020

Greece

CR

1

211.

Vuckovic et al

2020

Podgorica

CR

1

212.

Cecen et al

2021

Turkey

CR

1

213.

Chelliah et al

2021

USA

CR

1

214.

Darshan et al

2021

India

CR

1

215.

Gopan et al

2021

India

CR

1

216.

Martire et al

2021

Brazil

CR

1

217.

Santana et al

2021

Brazil

CR

1

218.

Torchalla et al

2021

Poland

CR

2

219.

Villanueva et al

2021

Spain

CR

1

220.

Williams et al

2021

USA

CR

1

221.

Baez et al

2022

USA

CR

1

222.

Krawczyk et al

2022

Poland

CR

1

223.

Lavanya et al

2022

India

CR

1

224.

Parosanu et al

2022

Romania

CR

1

225.

Singla et al

2022

India

PS

1

226.

Wallace et al

2022

UK

CR

1

Abbreviations: CR, case report, Co, correspondence, CP, clinicopathological study, CS, case series, OR, original research, PS, prospective study, RA, retrospective analysis, SR, systematic review, UK, United Kingdom, USA, United States of America.


Table 2

Clinical details of patients with renal cell carcinoma mediatizing to oral soft tissues (1911–2022)

Pt. no.

Age (in years)

Gender

Previous history of RCC/side of kidney

Medical history

Chief complaint

Oral site of metastasis

Clinical findings

Provisional diagnosis

Oral soft tissue as the initial site of metastasis?

Time of diagnosis of metastasis after nephrectomy

Any other organs involved in metastasis

Final diagnosis of metastatic RCC

1.

43

M

NA

NA

NA

T (SNA)

NA

NA

NA

NA

NA

CCC

2.

62

F

NA

NA

NA

T (SNA)

NA

NA

NA

NA

NA

CCC

3.

64

M

N

N

Difficulty in swallowing for 2 y

G (mand, R, ant)

Small epulis like growth

Epulis, SCC

Y

NA

CCC

4.

58

M

NA

NA

NA

T (SNA)

NA

NA

NA

NA

Lung, heart, skin

CCC

5.

57

M

NA

NA

NA

T (SNA)

NA

NA

NA

NA

NA

CCC

6.

54

M

NA

NA

NA

HP

NA

NA

NA

NA

NA

CCC

7.

61

M

NA

NA

NA

T (SNA)

NA

NA

NA

NA

Lung

CCC

8.

47

M

Y/NA

NA

NA

LL

NA

NA

N

9 mo

Lung, scalp

CCC

9.

62

M

NA

NA

NA

G (SNA)

NA

NA

NA

NA

Lung, bone, scalp

CCC

10.

60

M

NA

NA

NA

G (mand)

NA

NA

NA

NA

N

CCC

11.

63

F

N

NA

Pulsatile mass for 1 y

P (SNA)

Soft, fluctuant swelling

SGT

Y

NA

CCC

12.

NA

M

NA

NA

NA

G (mand)

NA

NA

NA

NA

NA

CCC

13.

77

M

Y/L

N

Painful mass

T (SNA)

Firm, painful swelling

SCC

N

3 wk

NA

CCC

14.

74

M

NA

NA

Difficulty in swallowing

Uvula

Soft, vascular mass

SCC

NA

NA

NA

15.

41

F

Y/L

NA

Abnormal sensation

T (SNA)

Small, soft swelling

PG

N

4 mo

Lung, LN, R kidney

CCC

16.

66

M

Y/L

NA

Difficulty in eating

P (SNA)

Firm, fixed mass

SGT

N

1 y

Bone

CCC

17.

69

M

Y/L

NA

Painless growth for few months

G (max R, post)

Soft, painless swelling, bleed on touch

PG, PGCG

N

2 y 3 mo

Brain, LN

CCC

18.

NA

NA

Y/R

Appendicitis

Difficulty in eating

BM (SNA)

Pedunculated, thumb-tip-sized, polyp-like tumor

NA

N

6 y

N

CCC

19.

63

M

NA

NA

Painless mass

Chin

Pedunculated crimson nodule

PG

NA

NA

NA

CCC

20.

84

M

Y/NA

NA

Swelling

T (tip)

Soft, painful swelling

SCC

N

NA

Lung

CCC

21.

43

F

Y/L

N

Painful swelling

HP

Polyp-like swelling developing into sequestrum

NA

N

15 y

N

CCC

22.

53

M

NA

NA

NA

HP

NA

NA

NA

NA

Lung, bone, liver

CCC

23.

62

M

NA

NA

NA

HP

NA

NA

NA

NA

N

CCC

24.

NA

NA

Y/NA

NA

Painful swelling

G (SNA)

Soft swelling

PG, PGCG

N

NA

NA

CCC

25.

55

M

N

N

Intraoral mass × 3–4 mo

P (R)

Soft ass

SGT

Y

NA

CCC

26.

65

M

Y/NA

N

Multiple swellings

G (SNA), P (SNA)

Nodular masses

PGCG, SGT

N

6.5 y

NA

CCC

27.

63

M

Y/NA

N

Difficulty in eating

G (SNA), T (dorsum)

Soft, vascular swelling on gingiva; soft pulsatile mass on tongue

PG

N

NA

Brain

CCC

28.

72

M

NA

NA

NA

G (SNA)

NA

NA

NA

NA

NA

CCC

29.

71

F

N

N

Mass below right angle of mandible for 9 mo

P (R)

Pulsatile, mobile swelling

SGT

Y

Liver, lung

CCC

30.

64

M

NA

NA

NA

G (SNA)

NA

NA

NA

NA

NA

CCC

31.

62

M

N

N

Mass on left preauricular region

P (L)

Swelling

SGT

Y

NA

CCC

32.

18

F

Y/NA

NA

Swelling

G (SNA)

Soft swelling

PGCG

N

14 y

Multiple

CCC

33.

61

M

N

N

Painless mass in mouth

SMG (L)

Firm, non-tender swelling

SGT

Y

N

CCC

34.

55

M

NA

NA

Difficulty in eating

HP

Highly vascular mass

NA

NA

NA

NA

CCC

35.

60

F

Y/NA

NA

Painful mass on right preauricular region

P (R)

Firm, non-tender swelling

SGT

N

8.5 y

SMG

NA

36.

54

F

NA

NA

Gum mass

G (SNA)

Soft, erythematous swelling

PGCG

NA

NA

N

CCC

37.

52

M

N

N

Mass on left preauricular region for 2 mo

P (L)

Soft, fluctuant swelling

SGT

Y

Lungs, ribs, lumbar spine, and brain

CCC

38.

57

M

N

N

Mass on tongue

T (base)

Soft, vascular, mass

SCC, any oral malignancy

Y

Lung, bone

CCC

39.

64

F

Y/NA

N

Mass on right preauricular region for 2 mo

P (R)

Swelling

SGT

N

10 y

N

CCC

40.

42

M

Y/L

N

Bleeding and pain

T (left)

Swelling, bleed on touch

PG

N

2 y

Lung, bone

CCC

41.

70

M

N

N

Mass for few months

T (SNA)

Painless swelling

NA

Y

NA

CCC

42.

77

F

N

NA

Swelling

T (left)

Painless swelling

NA

Y

Lung

CCC

43.

42

NA

N

NA

Rapidly growing mass

P (SNA)

Soft, firm swelling

NA

Y

Thyroid, max sinus

NA

44.

78

M

NA

NA

Masses in oral cavity

G (max, mand)

NA

NA

NA

NA

Lung, brain

CCC

45.

58

M

NA

NA

NA

T (SNA)

NA

NA

NA

NA

Lung, liver

CCC

46.

60

M

NA

NA

Painful mass

P (L)

Painful swelling

SGT

N

NA

NA

CCC

47.

46

F

NA

NA

NA

G (SNA)

NA

NA

NA

NA

Bone

CCC

48.

72

M

NA

NA

Mass on left preauricular lesion for 2.5 y

P (L)

Swelling

SGT

Y

Liver, lungs, mediastinum, adrenal

NA

49.

47

F

NA

NA

NA

NA

NA

NA

NA

NA

Bone

CCC

50.

55

M

N

NA

Intraoral ass × 3 mo

P (R)

Swelling

SGT

Y

Chest, brain, bone

CCC

51.

75

F

Y/L

NA

Pulsatile mass for 10 wk

P (L)

Swelling

SGT

N

8 y

Recurrent renal disease

CCC

52.

42

M

N

NA

Pulsatile mass

P (L)

Soft fluctuant, tender swelling

SGT

Y

Perirenal LN

CCC

53.

55

M

Y/R

NA

Painful mass for 6 wk

P (R)

Soft swelling

SGT

N

7 y

Lungs, axillary lymph nodes

CCC

54.

NA

NA

NA

NA

NA

G (SNA)

NA

NA

NA

NA

NA

CCC

55.

58

M

NA

NA

NA

G (SNA)

Soft erythematous mass

NA

NA

NA

Brain, lung, biceps

CCC

56.

73

M

NA

NA

NA

G (SNA)

Erythematous, bleed on touch

NA

NA

NA

Brain

CCC

57.

59

M

N

N

Mass on left preauricular region for 2 mo

P (L)

Firm swelling

SGT

Y

Cerebellum, vertebrae

CCC

58.

51

M

Y/L

N

Swelling, facial weakness

P (R)

Firm swelling

SGT

N

5 y

NA

CCC

59.

59

F

Y/L

N

Growth

T (left border)

Firm swelling, indurated borders

NA

N

5 y

Lung, brain, liver, kidney

CCC

60.

62

M

N

N

Swelling

G (both max, and max)

Vascular mass

PG

Y

Lung

CCC

61.

71

M

Y/NA

NA

Mass on the left side of the mouth for 3 mo

P (L)

Firm swelling

SGT

N

4 mo

Radius

CCC

62.

58

M

NA

NA

Swelling

T (SNA)

Soft painful swelling

PG

NA

NA

Lung

Brain

CCC

63.

55

F

Y/NA

NA

Bilateral masses for 3 mo

P (BL)

Painful swelling

SGT

N

7 y

NA

CCC

64.

41

M

Y/R

N

Difficulty in eating

T (base)

Pain, bleeding

NA

N

3 y

Lung, bone, lymph node

CCC

65.

44

M

Y/L

N

Pain in mouth

Cheek, UL

NA

NA

N (46, 51 mo)

4 y

NA

CCC

66.

59

M

N

N

Swelling

T (base)

NA

NA

Y

N

CCC

67.

51

M

NA

NA

Swelling

T (left surface)

Soft mass

PG

NA

NA

Lung, liver, brain

NA

68.

63

M

N

NA

Mass for 1 yr

P (R)

Soft mass

SGT

Y

Liver, pancreas

CCC

69.

59

M

N

NA

Mass for 3 wk on the left side of the mouth

P (L)

Soft mass

SGT

Y

Perirenal lymph nodes

CCC

70.

40

M

N

NA

Swelling

P (R)

Soft mass

SGT

Y

NA

CCC

71.

59

M

N

NA

Swelling

P (R)

Soft mass

SGT

Y

NA

CCC

72.

82

F

N

N

Gradually increasing swelling

T (Tip)

Pedunculated, reddish blue, hemorrhagic lesion

PG, Primary tongue carcinoma, Metastatic

Y

Brain

CCC

73.

73

F

NA

NA

Difficulty in swallowing

Wharton duct (R)

NA

NA

NA

NA

NA

CCC

74.

NA

NA

NA

NA

Difficulty in swallowing

To

Soft fluctuant swelling

Peritonsillar abscess

NA

NA

NA

CCC

75.

59

M

N

N

Tumor for 2 y

T (SNA)

Soft fluctuant swelling

PG, Primary or metastatic tongue carcinoma

Y

LN

CCC

76.

48

M

N

NA

Mass on left side neck for 3 mo

P (L)

Soft, painless mass

SGT

Y

Right adrenal

CCC

77.

56

F

Y/ L

N

Painful mass

To (R)

Soft, fluctuated swelling

NA

N

6 mo

NA

CCC

78.

52

M

Y/L

N

Rapidly growing mass on tongue

T (left surface)

Pedunculated, reddish blue, hemorrhagic lesion

PG, Primary or metastatic tongue carcinoma

N

10 mo

Lung, brain, skin

CCC

79.

50

M

Y/R

N

Rapidly increasing painful mass for 2 mo

P (L)

Enlarged parotids, a solid, well-circumscribed tumor, deeply adhering without FN involvement

SGT

N

5 y

N

CCC

80.

52

M

Y/R

NA

Intraoral mass

P (R)

Rapidly increasing painless mass

SGT

N

5 mo

LN

CCC

81.

50

M

N

NA

Mass

T (SNA)

Soft swelling

PG

Y

Lung

CCC

82.

NA

NA

N

NA

Swelling

T (SNA)

Firm swelling

SCC, PG

Y

N

CCC

83.

61

M

N

N

Facial weakness on right side

Face

Outer skin

(R)

NA

NA

Y

R. adrenal, bone, skin, pulmonary, cerebral

CCC

84.

63

M

Y/NA

NA

Rapidly growing masses on both sides of face

P (BL)

3 × 2.5 cm firm mass in both glands

SGT

N

14 y

NA

CCC

85.

74

M

NA

NA

Swelling on tongue

T (SNA)

NA

NA

NA

NA

NA

CCC

86.

83

F

Y/NA

NA

Mass ×2 mo on the left preauricular region

P (L)

Firm, nodular swelling

SGT

N

10 y

N

CCC

87.

63

M

Y/NA

NA

Swelling and pain on tongue

T (SNA)

Swelling firm

PG

N

20 y

NA

CCC

88.

83

F

Y/NA

NA

Mass ×2 mo on left preauricular region

P (L)

Firm, nodular swelling

SGT

N

10 y

Y

CCC

89.

60

M

NA

NA

Dysphagia

T (SNA)

NA

NA

NA

NA

Lung

CCC

90.

70

M

NA

NA

Swelling

LL

NA

NA

NA

NA

Abdomen

CCC

91.

62

M

NA

NA

Swelling on tongue

T (base)

Soft sessile mass

PG

NA

NA

Lung

CCC

92.

45

M

Y / L

N

Dyspnea, cough, lethargy for 2 mo

T (tip)

Pedunculated, firm mass

NA

N

2 mo

Lung, nose

CCC

93.

59

F

Y/L

NA

Swelling on the left side of the face

P (L)

Firm, nodular

SGT

N

10 y

Other kidney

CCC

94.

57

F

N

N

Painful swellings on the left side of the face for 3 wk

BM (L)

3.3-cm oval shaped, hard swelling

NA

Y

Humerus

CCC

95.

66

M

Y/L

N

Discomfort in mouth

T (base)

Tumor mass

NA

N

3 y

Lung

CCC

96.

87

F

Y/R

N

Exophytic ulcerated mass

T (post)

Malignant oral tumor

NA

N

10 y

Lung, liver, pancreas, thyroid

CCC

97.

86

M

Y/L

NA

Multiple masses in oral cavity, face, neck, and scalp

Lip, SP

Popular masses

NA

N

4 y

Lung, leg, bone

CCC

98.

67

M

N

N

Mass on the left side of the mouth for 4 mo

P (L)

SGT

Y

Adrenals, lung, LN

CCC

99.

73

M

Y/L

N

Tumor

T (left side)

Partially ulcerated protruding mass

PG

N

10 y

Scapula, choroid, LN, brain

CCC

100.

41

M

NA

NA

Swelling on tongue and scalp

T (SNA)

Soft mass

NA

NA

NA

Lung, scalp, bone, brain

CCC

101.

76

F

Y/R

NA

Hemoptysis, dysphagia

T (base)

Fungating, bluish-purple lesion without cervical lymphadenopathy

NA

N

8 y

Lung, liver

CCC

102.

83

M

Y/NA

N

Swelling

SMG (SNA)

Firm, nodular lesion

SGT

N

10 y

N

CCC

103.

NA

NA

NA

NA

NA

P (SNA)

NA

NA

NA

NA

NA

CCC

104.

36

M

N

N

Rapidly growing lesion, abscess in the chin

Chin

Afebrile, erythematous, tender lesion

Abscess

Y

N

CCC

105.

61

M

Y/NA

NA

Difficulty in swallowing

To (R)

Pedunculated mass

NA

N

11 mo

Lung, brain

CCC

106.

49

F

NA

NA

Difficulty in breathing

T (SNA)

Smooth, painless swelling

Primary oral tumor

NA

NA

Lung

CCC

107.

NA

NA

Y/L

NA

Rapidly growing mass

P (SNA)

NA

NA

N

5 y

NA

CCC

108.

NA

NA

Y/L

NA

Growth on left side

P (SNA)

NA

NA

N

10 y

NA

CCC

109.

81

M

Y/R

Hypothyroidism, BPA

Tumor like mass for weeks

T (Post lat)

Polylobate fragile mass 2 × 1 cm

Oral CCC

N

3 y

Lung

CCC

110.

74

M

Y/N

N

Painful swelling on the right side

SMG (R)

Firm mass

NA

N

NA

NA

CCC

111.

78

M

Y/NA

N

Painful swelling on the right side

SMG (R)

Firm mass, non-fixed

NA

N

NA

NA

CCC

112.

74

F

Y/R

N

Right side preauricular swelling for 3 mo

P (R)

Painful, firm, 2 × 2 cm, no FN involvement

SGT

N

7 y

Ad gland

CCC

113.

82

m

Y/L

N

Painless mass

T (right side)

Soft elevated smooth red mass no bleeding

Na

N

4 y

Lung brain

CCC

114.

78

M

N

S

Difficulty in swallowing for 6 wk

T (R side ant 2nd/3rd)

Pedunculated mass

SCC

Y

N

CCC

115.

68

M

N

S

Gradually increasing painless mass in right periauricular region for 1 y

P (R)

Hard, firm, nontender, deeply adhering mass

SGT

Y

Lung, liver

CCC

116.

68

M

NA

NA

Swelling on tongue

T (SNA)

Soft swelling

PG

NA

NA

NA

CCC

117.

58

F

N

NA

Tender mass

P (R)

Painful swelling

SGT

Y

Meatus

CCC

118.

75

F

Y/NA

NA

Painful mass

P (L)

Tender mass

SGT

N

9 y

Contralateral kidney, lung, bone

CCC

119.

62

M

YNA

NA

Painful mass for few years

P (L)

Tender mass

SGT

N

5 y

Y

CCC

120.

74

M

N

Polyarthralgia

Swelling in lower gingiva for 1 mo

G (mand, A, BL)

Painless, erythematous, vascular, granulomatous lesion of 3 × 2 cm

NA

Y

Lung, brain

NA

121.

67

M

Y/R

CRF

Swelling

P (R)

Deeply adherent painless mass

NA

N

15 y

LN

CCC

122.

63

M

Y/R

N

Pain in right neck and tongue

T (SNA)

Swelling attached to FOM

NA

N

4 mo

LN

CCC

123.

46

F

Y/NA

N

Swelling on tongue

T (SNA)

Soft nontender mass

PG, OSTT

N

3 y

Lymph node

CCC

124.

64

M

Y/L

N

Swelling right auricle

P (R)

Round, painless, immobilized mass, 2 × 2 cm

SGT

N

10 y

N

CCC

125.

70

M

Y/R

NA

Lump on tongue

T (ant, right)

Nodule

Oral metastatic tumor

N

18 y

Multiple

CCC

126.

67

F

N

NA

Swelling on tongue while biting

T (ant 3rd)

Soft, vascular, painful nodule

NA

Y

Thyroid

CCC

127.

75

M

N

N

Swelling in right preauricular region for 6 mo

P (R)

Firm nodular mass, 4 × 3 mm

Warthin tumor

Y

Liver, vertebrae, lung, adrenals

CCC

128.

78

M

Y/R

Cholecystectomy

Rapidly increasing swelling for 2 mo

P (SNA)

Hard, painless mass of 3 × 3 cm

SGT

N

3 y

N

CCC

129.

52

M

N

N

Gingival bleeding, swelling

G (max, ant)

Polypoid mass

PG

Y

Phalanx of finger

CCC

130.

63

M

NA

NA

Gum mass

G (max)

Exophytic growth

Epulis

NA

NA

Femur, vertebrae, ribs, pelvis

CCC

131.

76

M

Y/L

S, HT, COPD, BA, anemia

Difficulty in eating

To (R)

Grey, vegetated mass

NA

N

6 y

Lung, bone

CCC

132.

63

F

Y/R

N

Swelling

T (right side of mid of base)

Soft, smooth swelling

Lipoma, neuroma,

N

7 y

NA

CCC

133.

67

M

N

N

Rapidly growing swelling tongue lesion

T (dorsum)

Large, irregular, fungating, reddish-blue, 4.8 cm

SCC

Y

Lung, abdomen, throat

CCC

134.

61

F

Y/L

Mastectomy, BC

Painless and palpable swellings in thyroid and mid mouth region

SMG (R)

Firm mass

Thyroid tumor

N

7 y

Thyroid

CCC

135.

27

M

N

NA

Swelling on tongue

T (SNA)

Soft cystic swelling

NA

Y

Spine, lung, liver

CCC

136.

75

M

N

N

Swelling in upper front region

G (max, ant)

NA

NA

Y

Brain, lung

CCC

137.

59

M

N

N

Nodule on upper lip for 2 mo

UL

NA

NA

Y

Lung, brain

CCC

138.

61

F

N

N

Mass on the left side of the face

P (L)

Enlarged size of parotid region

SGT

Y

Skin, pancreas

CCC

139.

74

M

Y/L

N

NA

G (SNA)

NA

NA

N

1 y

Brain, lung, liver

TCC

Renal pelvis

140.

47

M

Y/L

N

Swelling and severe pain in the upper gingiva

G (max)

Painful swelling

NA

N

8 mo

Lung

CCC

141.

60

M

Y/R

N

Swelling on the right side of mouth

P (R)

Painful swelling

SGT

N

3 y

N

CCC

142.

48

F

Y/R

N

Painful swelling

T (left lateral border)

Nodule crossing midline

OSTT

N

4 y

Bone, lymph node

CCC

143.

35

M

N

Abdominal lump

Gradually increasing swelling

P (L)

Firm swelling

SGT

Y

N

CCC

144.

48

M

Y/L

MM

Dysphagia and dysphonia and mass on the tongue

T (base)

(5 × 5 cm) exophytic swelling in the oropharynx with epicenter in the right base of tongue involving the tonsillar fossa and adjacent soft palate on right side, crossing midline

NA

N

5 y

Lung, bone, adrenal, lymph node

CCC

145.

47

M

N

N

Swelling on tongue

T (dorsum)

Pedunculated firm swelling

PG, primary carcinoma of oral cavity

Y

N

CCC

146.

72

M

N

N

Rapidly increasing painless mass

T (right side)

Soft swelling

NA

Y

Lung

CCC

147.

82

M

Y/R

CLL, left adrenalectomy

Mass on R preauricular region for 18 mo

P (R)

Swelling

Lymphoma

N

19 y

N

CCC

148.

70

M

Y/R

N

Mass on tongue

T (left side)

Ulcerated, hemorrhagic mass

NA

N

15 y

Lung, bone, adrenal, lymph node

CCC

149.

64

F

Y/L

End-stage LC

Painless lump on tongue, growing rapidly in 4 wk

T (ant)

Firm, well-defined nontender lump, 5 cm

Metastatic

N

17 y

N

CCC

150.

65

M

Y/L

NA

Discomfort in left cheek

BM (L)

NA

NA

N

19 y

N

CCC

151.

79

F

Y/L

NA

Difficulty in eating

P (L)

Non tender soft swelling

SGT

N

16 y

N

CCC

152.

71

M

Y/R

HT, S

Mass for 2 y

P (R)

Non tender soft swelling without lymphadenopathy

NA

N

5 y

Pancreas

CCC

153.

63

F

Y/NA

NA

Painless, non-ulcerated, nodular mass

T (right side)

Swelling

PG

N

7 y

N

CCC

154.

63

M

NA

NA

Nodule

G (max, BL)

Exophytic mass

PGCG

NA

NA

MM

CCC

155.

NA

NA

Y/NA

NA

Hard mass

SMG (SNA)

NA

NA

N

9 y

NA

CCC

156.

72

F

Y/L

N

Hemoptysis, dysphagia

To (L)

Painful, exophytic, grayish, ulcerated mass

NA

N

3 y

Lung

CCC

157.

66

M

N

S, HT

Lesion on tongue

T (dorsum)

Exophytic mass

NA

Y

––

Visceral organs

CCC

158.

65

M

N

N

Growth for 2 mo

T (dorsum)

Pedunculated growth

NA

Y

Lung, muscles, LN

CCC

159.

73

M

N

Weight loss

Multiple painless swellings in the lower gingival region

G (mand, BL)

Three soft, reddish brown swellings

(35–36, 37–38, 44–46 region)

3 × 2.5 cm, 2 × 1 cm, and 1 × 1 cm, respectively

NA

Y

N

CCC

160.

61

M

Y/R

Drug allergy, anemia, family history of RCC

Painless mass in right side of mouth

P (R)

Firm, painful mass

SGT

N

5 y

Lung, adrenal

CCC

161.

44

F

N

N

Painless mass in left side of mouth

P (L)

Painless swelling

SGT

Y

Lung, liver, bone

CCC

162.

80

M

Y/NA

HT

Swelling

T (dorsum)

Oval, reddish, sessile, painless mass

SGT, PG

N

4 y

N

CCC

163.

62

M

N

HT

Palpable swelling left preauricular

P (L)

Bony hard mass

PA

Y

N

CCC

164.

NA

NA

Y/NA

NA

Mass on left side

P (L)

Nodular, firm swelling

SGT

N

11 y

NA

CCC

165.

63

M

N

NA

Difficulty in eating for 3 mo

T (dorsum)

Soft swelling

Oral malignant tumor of clear cell variant

Y

Lung

CCC

166.

64

M

Y/NA

S, A

Rapidly growing swelling for 3 wk

LL

Soft erythematous, 4 cm

SCC, keratoacanthoma

N

6 mo

Lung

CCC

167.

62

M

Y/NA

N

Soft enlarging swelling

SP (R, post)

Red, fungating and ulcerated mass 3 × 2.5 cm. and bled on touch

NA

N

1 mo

N

CCC

168.

67

M

N

N

Rapidly growing mass in left side of mouth for 1 y

P (L)

Painless mass 2 × 2 cm

SGT

Y

N

CCC

169.

64

F

N

N

Slowly progressive left facial swelling for few months

P (BL), SMG (L)

Painless masses

SGT

Y

Thyroid

CCC

170.

67

M

N

HT, BA, prostate infection, UTI

Painful lesion for 3 mo

HP (R side)

Tender irregular lump ∼2–3 cm

NA

Y

N

CCC

171.

71

M

Y/R

N

Tumor mass on lower lip

LL

Soft, pulsatile mass 1.5 cm

NA

N

3 y

Lung, mediastinum

CCC

172.

70

M

Y/L

IHD, bypass surgery

Left cheek swelling, hematuria

P (L)

Hard, fixed tender mass of size 2 × 2 cm

SGT

N

15 y

Contralateral kidney, right adrenal

CCC

173.

64

M

Y/L

NA

Mass under his right ear for several weeks

P (R)

1.0 × 1.0 cm firm, painless, mobile mass

SGT

N

6 y

Lung

CCC

174.

67

M

N

N

Rapidly growing mass

T (dorsum)

Large, irregular, fungating, reddish-blue, 4.8-cm mass

SCC with clear cell variant

Y

Lung

CCC

175.

77

F

Y/BL

FNP (R side, hemi cranial pain (R side)

Right neck mass extending to right parotid and thyroid glands

P (R)

Hyper vascular mass, lymphadenopathy

Metastatic

N

3 y

Thyroid

CCC

176.

60

M

Y/L

A, tobacco

Asymptomatic rapidly increasing growth on the upper lip, present for 3 mo

UL

Exophytic, dome-shaped, ulcerated reddish pink nodule 2 × 1.5 cm

KA

N

5 mo

Lung, liver

CCC

177.

83

M

Y/R

N

Rapidly growing mass

P (R)

Firm swelling

SGT

N

10 yr

Cerebellum

CCC

178.

53

F

Y/L

Dialysis

Firm mass in the mouth

SMG (L)

Hard, round, fixed

SGT

N

4 yr

NA

CCC

179.

82

F

Y/L

NA

Rapidly enlarging mass

P (L)

Firm, nodular swelling

SGT

N

6 y

NA

CCC

180.

56

F

Y/R

Thyroid resection

Right preauricular painless mass present for 6 mo

P (R)

Smooth, firm, immobile and non-tender mass 3 × 3 cm

SGT

N

11 y

N

CCC

181.

60

M

N

N

Enlarging mass for 5 mo

G (mand, L, ant, post)

Painless, nodular fungating mass of 6 × 7 cm

Fibroma

Y

Lung

CCC

182.

66

F

Y/L

N

Painful swelling in the right side of mouth

P (R)

Well-defined, 37 × 21 mm in size, hypoechoic heterogeneous solid mass

NA

N

15 y

N

CCC

183.

70

M

Y/R

HT

Growing lesion in the right side of mouth

P (R)

Painless, soft, smooth 3 × 4 cm mass

NA

N

11 y

N

CCC

184.

31

F

Y/NA

NA

Gingival mass

G (mand)

NA

PGCG, PG

N

NA

Abdomen

CCC

185.

65

M

Y/R

SCC of right pinna

Right preauricular swelling

P (R)

Nodule

SGT

N

8 y

N

CCC

186.

36

F

N

AN

Nonhealing, painful ulcer in the right side for 2 mo

BM (R)

Ulcer proliferative growth 4 cm × 2 cm with raised shelf-like inferior margin and submucosal induration

Benign or malignant oral tumor

Y

Liver, bone

CCC

187.

66

F

N

NA

Painless, enlarging, hard, immobile mass, FNP

P (R)

Nontender, firm mass 5 × 4 cm, FNP

SGT

Y

N

CCC

188.

76

F

N

NA

Painless, enlarging, immobile mass

P (R)

Non-tender soft mass, 5 × 5 cm

SGT

Y

N

CCC

189.

97

F

N

NA

Hard, immobile mass

SMG (R)

Firm, nodular swelling

SGT

N

(At the time of diagnosis)

N

CCC

190.

68

M

N

NA

Growing firm painless mass for 4 mo

P (L)

Non-tender, firm swelling, 2.6 × 1.8 × 1.3 cm

SGT

Y

N

CCC

191.

69

M

N

NA

Palpable mass

P (L)

Firm hard swelling, 1.8 × 1.5 × 2 cm

SGT

Y

N

CCC

192.

NA

M

Y/NA

NA

Painless slowly growing mass for 3 mo

P (R)

Non-tender mass

SGT, metastatic

N

NA

Lung

CCC

193.

NA

F

Y/NA

NA

Tumor

Minor glands, left retromolar)

Soft, fluctuant swelling

SGT, metastatic

N

NA

Y

CCC

194.

NA

F

Y/NA

NA

Palpable tumor

P (R)

Firm, nodular mass, 1.5 cm

SGT

N

NA

Y

CCC

195.

60

F

N

NA

Swelling

P (R)

Multinodular palpable mass in the area of cicatrix

PA

Y

Y

CCC

196.

56

M

N

N

Swelling in upper region of mouth

HP

Firm, nodular swelling

Nodular fasciitis

Y

Ad, femur

CCC

197.

74

F

N

N

Swelling on left side of mouth

P (L)

Well-demarcated painless mass

SGT

Y

N

CCC

198.

51

M

Y/NA

NA

Swelling

G (max)

Soft, erythematous mass

PG

N

NA

Scalp, phalanx of the fifth digit

CCC

199.

45

M

N

Nephrolithiasis

Rapidly growing gingival mass

G (max, ant, BL)

Red-purple, sessile, exophytic mass extending to palate

Lymphoma, metastatic tumor

Y

N

CCC

200.

71

F

Y/NA

N

Tumor mass

T (tip)

Soft 10-mm swelling, bleed

PG

N

10 y

Hilar lymph node, lungs

CCC

201.

54

M

N

H/O extraction of 2nd molar 7 d before, hematuria

Oral lesion with erythema and swelling of the left lower side

G (mand, L, post)

Soft, erythematous mass

PG

Y

N

Collecting duct AC

202.

63

M

N

HT

Multiple painless reddish nodules on the gums, and the scalp

G (SNA)

3 in number, reddish in color, and intermittently bled ranging in size from 1 × 2 cm to 4 × 3 cm

PG, metastatic

Y

Lung, liver, bone

CCC

203.

56

NA

Y/NA

NA

NA

T (SNA)

NA

NA

N

5 mo

Lung, mediastinum

CCC

204.

74

NA

Y/NA

NA

NA

P (SNA)

NA

NA

N

6.5 y

N

CCC

205.

58

M

Y/NA

N

Growing mass, painful

G (max, R, ant)

Non-ulcerated mass without bleeding

Epulis

N

NA

Lung, brain, left occipital

CCC

206.

55

M

N

Tobacco, HT

Painful lesion

T (ant 2nd/3rd)

Exophytic growth

OSTT

Y

Lung, muscle

CCC

207.

NA

NA

NA

NA

Swelling on face

P (SNA)

NA

Oncocytoma

NA

NA

NA

CCC

208.

51

M

N

S, A

Difficulty swallowing, for 5 mo

T (base)

NA

NA

Y

Lung, liver, LN

CCC

209.

74

F

Y/L

Colorectal cancer

Rapidly growing painless mass in the left preauricular region

P (L)

Mobile mass

SGT/ Metastatic

N

11 y

Lung, liver

CCC

210.

80

F

Y/L

Colorectal cancer, parotid metastasis of left side

Rapidly growing painless mass in the right preauricular region

P (R)

Vascular mass 1.5 cm

Metastasis

N

17 y

N

CCC

211.

64

M

Y/L

Left choroid metastasis from RCC

Growth in the oral cavity for 1 mo

HP

Nodular mass, 5 × 3 cm, bleed easily

NA

N

1 y

Lungs, pancreas, adrenal. Infratemporal fossa

CCC

212.

74

F

Y/L

N

Hard nodule

SMG (R)

Firm vascular swelling

NA

N

11 y

N

CCC

213.

55

F

Y/R

N

Congestion

Uvula

Uvular erythematous mass with vascularity, ∼2 mm in size, and a 2-mm papillomatous lesion in the left hard palate

OSTT

N

3 y

Pancreas, max sinus, ethmoid sinus, lungs

CCC

214.

54

M

Y/L

N

Swelling over upper lip, scalp, and retromolar region

UL, retromolar (R)

Lip: Exophytic, firm, non-tender mass, 2 × 1.8 cm

Retromolar: firm, diffuse growth 6 cm × 4.5 cm × 3.2 cm

PG, KS, AS

N

2 mo

Multiple

CCC

215.

75

M

Y/L

Myoepithelioma on left BM 7 y, ago

Rapidly growing lesion on left BM for weeks

BM (L)

Soft mass with a smooth surface 40 × 30 mm, facial asymmetry

Recurrent myoepithelioma

N

26 y

N

CCC

216.

61

M

Y/NA

Retroperitoneal lymph node dissection

Swelling tongue for 2 mo

T (tip)

Tender hemorrhagic mass

NA

N

20 y

N

CCC

217.

78

F

N

N

Enlarging soft tissue mass of several months

G (max, BL, ant)

Fluctuant, dark-red, exophytic lesion extending from the 12–21, 3.0 cm × 1.5 cm size

PG

Y

Right femoral head and greater trochanter

CCC

218.

54

M

Y/NA

COPD, DM, HT

Dyspnea

T (tip)

Sessile, papillary mass

Immune reaction

N

NA

Finger

CCC

219.

82

M

Y/NA

N

Mass on lower gingiva right side

G (mand, R, post)

Nodule with necrosis at center

PG, PGCG

N

NA

Femur, ribs

CCC

220.

63

M

Y/R

N

Difficulty in eating for 2 mo

To (R)

Exophytic, greyish and edematous mass

NA

N

5 y

N

CCC

221.

77

M

Y/L

N

Traumatic mass

T (dorsum)

Pedunculated, vascular lesion

PG, Benign

N

17 y

Liver, lung, atrium

CCC

222.

59

M

N

N

Painless ulcerative lesion in side of mouth

BM (L)

Non-fluctuant, ulcerated mass

SCC

Y

Lungs

CCC

223.

68

M

N

S, A, HT, gastritis, appendicitis

Rapidly increasing mass on the right side of the face

BM (R)

Firm, well-defined tumor-like lesion, slight elevation in the ipsilateral jugal mucosa

Benign or malignant soft tissue tumor

Y

N

CCC

224.

75

F

Y/L

S, A, recurrent RCC

Mass growing for 18 mo on left side of mouth

P (L)

Painless swelling, 4 × 4 cm

PA

N

10 y

N

CCC

225.

50

M

NA

NA

Rapidly growing mass on one side of face

P (SNA)

NA

NA

NA

NA

NA

CCC

226.

74

M

L

N

Difficulty in swallowing for several months

T (base)

Swelling

NA

N

2 y

Liver, thyroid, ileac bone

CCC

227.

50

M

N

N

Pain radiating to right ear for 5 mo

P (R)

Non tender swelling, trismus, lymphadenopathy

TN

Y

LN

CCC

228.

63

M

N

DM, HT

Rapidly growing intraoral mass for 2 mo

G (max, L)

Nodule, bleed easily, 5 × 3 cm, foul smell

PG, Malignant oral tumor

Y

Liver, lung, brain

CCC

229.

61

M

NA

NA

Rapidly increasing mass for 3 wk

T (left side)

Soft, erythematous swelling

PG, SCC

NA

NA

NA

CCC

230.

71

M

NA

NA

Swelling

BM (SNA)

Firm, nodular mass

Soft tissue tumor

NA

NA

NA

CCC

231.

59

F

N

Hip and back pain, GBS, right nephrectomy done for benign growth in 2014

Swelling on left side of mouth interfering dentures

BM (L)

Edentulous, with a pink-red, oval, ulcerated lesion measuring ∼38 × 25 × 17 mm

PG, SCC, Metastatic, soft tissue tumor

Y

Multiple sites

CCC

232.

53

M

N

Back pain

Rapidly growing tumor mass associated with bleeding, eating difficulty

G (mand, R, post)

Exophytic tumor mass, sized ∼ 6 × 3 cm, facial asymmetry

NA

Y

N

PCC

233.

65

F

Y/R

Appendectomy, cholelithiasis, and thyroid nodules, MM of RCC

Rapidly growing mass

BM (L)

Soft vascular mass with a smooth surface, 2.7 × 0.8 × 0.9 cm in growing 3rd molar region

Gingival hypertrophy

N

4 y

Adrenals, lung, spine, bone

CCC

234.

79

M

Y/L

N

Swelling

T (body)

Clearly demarcated smooth mass

NA

N

7 y

Lungs

CCC

235.

63

F

Y/L

TB

Rapidly growing mass for 3 wk

LL

2 × 1 cm hemorrhagic, ulcerated mass

NA

N

10 y

Brain, lung

CCC

236.

45

F

Y/NA

N

Painful bleeding nodule on chin for 4 mo

Chin

0.8 × 0.9 × 0.7 cm nodule

PG, KS,

N

7 y

N

CCC

237.

50

M

Y/R

NA

Swelling on upper lip

UP

Exophytic, firm, tender, pedunculated base, non-pulsatile, 4 × 3 cm

PG

N

3 y

N

CCC

238.

NA

NA

NA

NA

NA

P (SNA)

NA

NA

NA

NA

NA

CCC

239.

69

M

N

S, A

Nodule in the right parotid region for 3 mo

P (R)

Nodule, vascular

SGT

Y

N

CCC

240.

72

M

Y/R

N

Facial swelling for 1 y

P (SNA)

Nodular growth

SGT

N

8 y

N

CCC

241.

81

M

Y/L

HT, glaucoma, osteoarthritis

Tumor mass on left side of mouth

SMG (L)

Vascularized, solid mass, 24 × 21 × 26 mm in diameter

SGT

N

8 y

N

CCC

242.

84

M

Y/L

HT, glaucoma

Tumor mass on right side of mouth

SMG (R)

Painless, soft, movable tumor, ∼ 2 × 2 cm in diameter

Metastatic

N

11 y

N

CCC

243.

60

M

Y/R

DM, HT

Gum mass

G (max, L, ant)

Exophytic, erythematous lesion with a granulomatous appearance, 2 cm in size

PG, PGCG, SCC, Metastatic carcinoma

N

5 y

N

CCC

244.

59

M

Y/ R

N

Rapidly growing painless nodule for 1 mo

LL

Nodule crossing vermillion border

PG, SCC, Metastatic carcinoma

N

7 y

N

CCC

245.

75

F

Y/R

DM, cardiac arrhythmia, pacemaker

Bleeding gums for 10 d and tumor-like growth

G (max L, ant)

Facial asymmetry, deformed left UL, tumor mass in 22–23 region, 22 missing, mobile 21, 23

PGCG

N

2 y

Multiple

CCC

246.

54

M

N

HT, nicotine

Painless rapidly growing mass on left preauricular region for 6 mo

P (L)

Palpable mass with lymphadenopathy

SGT

Y

Lung, neck, rib

CCC

247.

58

M

Y/R

DM, HT, hypothyroidism

Loss of appetite, disorientation, drowsiness, and ulcer in the mouth

BM (L)

Ulcerated growth

NA

N

1 y

Brain, scalp

CCC

248.

75

F

N

HT, DM, colon cancer, CAD, diabetic nephropathy

Painful swelling on left preauricular region

P (L)

Firm, nodular growth

SGT

Y

Vertebrae

CCC

249.

59

M

Y/R

N

Preauricular swelling right side

P (R)

6 × 4 cm nodular, vascular, mass

NA

N

4 y

N

CCC

250.

52

M

Y/NA

S, HT, DM, IHD

Sore throat for 2 wk

Uvula

Protruding mass

Polyp, benign, or malignant oral tumor

N

1 y

Lung, liver, skeletal

CCC

Abbreviations: A, alcohol; Ant, anterior; AN, areca nut; AS, angiosarcoma; BA, bronchial asthma; BL, bilateral; BM, buccal mucosa; BOP, bleeding on probing; BPA, benign prostate atrophy; COPD, chronic obstructive pulmonary disease; CRF, chronic renal failure; DM, diabetes mellitus; F, female; FNP, facial nerve palsy; G, gingiva; GBS, Guillain Barr syndrome; HOE, history of extraction; HP, hard palate; HT, hypertension; I, ischemic heart disease; L, left; LC, lung cancer; LL, lower lip; M, male; MS, multiple sites; N, no; NA, not available; OSTT, oral soft tissue tumor; P, parotid; HP, hard palate; KA, keratoacanthoma; KS, Kaposi sarcoma; PG, pyogenic granuloma; PGCG, peripheral giant cell granuloma; Post, posterior; R, right; RCC, renal cell carcinoma; S, smoking; SCC, squamous cell carcinoma; SGT, salivary gland tumor; SM, skeletal muscles; SMG, submandibular gland; SNA, site not available; SP, soft palate; T, tongue; TCC, transitional cell carcinoma; To, tonsil; TN, trigeminal neuralgia; UL, upper lip; UTI, urinary tract infection; Y, yes; y, years.


Table 3

Data describing treatment and prognosis of patients with renal cell carcinoma metastasizing to the oral soft tissues (1911–2022)

Patient no.

Treatment done

Prognosis

Survival time from DOM to D (in months)

Reason for death

1.

NA

NA

NA

NA

2.

NG

D

3

NA

3.

Died before diagnosis, diagnosed at autopsy

4.

NG

D

1

MM

5.

NA

NA

NA

NA

6.

NA

NA

NA

NA

7.

S

D

5

NA

8.

NA

NA

NA

NA

9.

NA

NA

NA

NA

10.

NA

NA

NA

NA

11.

S, R

NA

NA

NA

12.

NA

NA

NA

NA

13.

S

NA

NA

NA

14.

NA

NA

NA

NA

15.

NG

D

1

NA

16.

NA

Fav/Alive

17.

NA

D

1

NA

18.

E, R

FAV

19.

S

NA

NA

NA

20.

S

D

3

NA

21.

Systematic

Fav

22.

NA

NA

NA

NA

23.

NA

NA

NA

NA

24.

NA

NA

NA

NA

25.

Superficial parotidectomy

NA

NA

NA

26.

NA

NA

NA

NA

27.

S, R

D

3

NA

28.

NA

NA

NA

NA

29.

S

Fav

30.

NA

NA

NA

NA

31.

Deep parotidectomy

NA

NA

NA

32.

NA

NA

NA

NA

33.

S

NA

NA

NA

34.

Cryotherapy

NA

NA

NA

35.

S

NA

NA

NA

36.

NA

NA

NA

NA

37.

Superficial parotidectomy

NA

NA

NA

38.

S

Fav

39.

S

NA

NA

NA

40.

R, C

D

7

NA

41.

S

NA

NA

NA

42.

C, I

D

2

NA

43.

S

D

NA

NA

44.

NA

NA

NA

NA

45.

NA

NA

NA

NA

46.

Partial parotidectomy

NA

NA

NA

47.

NA

NA

NA

NA

48.

Palliative radiotherapy

NA

NA

NA

49.

NA

NA

NA

NA

50.

Superficial parotidectomy

NA

NA

NA

51.

Complete parotidectomy

NA

NA

NA

52.

Superficial parotidectomy

D

20

NA

53.

S, R

D

46

NA

54.

NA

NA

NA

NA

55.

NA

NA

NA

NA

56.

NA

NA

NA

NA

57.

Superficial parotidectomy

NA

NA

NA

58.

Parotidectomy

NA

NA

NA

59.

S

D

6

Hepatic insufficiency

60.

NA

NA

NA

NA

61.

Superficial parotidectomy

NA

NA

NA

62.

S

D

3

NA

63.

Superficial parotidectomy

Fav

64.

I

D

6

MM

65.

NA

NA

NA

NA

66.

S, R, I

D

6

NA

67.

S

D

2

NA

68.

Partial parotidectomy

NA

NA

NA

69.

NA

NA

NA

NA

70.

NA

NA

NA

NA

71.

Superficial parotidectomy

NA

NA

NA

72.

S

D

36

MM

73.

NA

NA

NA

NA

74.

S

NA

NA

NA

75.

S, I

Fav

76.

Superficial parotidectomy

NA

NA

NA

77.

NA

NA

NA

NA

78.

R

D

12

RF

79.

Complete parotidectomy

Fav

80.

S

NA

NA

NA

81.

R, C, I, IL

D

16

Lung metastasis

82.

Tumor resection

Fav

83.

R

NA

NA

NA

84.

NA

NA

NA

NA

85.

NA

NA

NA

NA

86.

Parotidectomy (TNA) and nephrectomy

NA

NA

NA

87.

NA

NA

NA

NA

88.

Superficial parotidectomy

NA

NA

NA

89.

E

NA

NA

NA

90.

C

NA

NA

NA

91.

S, I, IL

NA

NA

NA

92.

S, R

D

NA

NA

93.

Superficial parotidectomy

NA

NA

NA

94.

Palliative, blood transfusion

D

NA

Uncontrolled bleeding

95.

S, I

Fav

96.

S

D

5

MM

97.

NA

NA

NA

NA

98.

Superficial parotidectomy

NA

NA

NA

99.

R

D

NA

RF

100.

S, C

NA

NA

NA

101.

S

D

1

MM

102.

Superficial parotidectomy

NA

NA

NA

103.

Parotidectomy

NA

NA

NA

104.

S, R, C, I

Fav

105.

S

D

6

NA

106.

S

NA

NA

NA

107.

NA

NA

NA

NA

108.

NA

NA

NA

NA

109.

S

Fav

NA

NA

110.

S

NA

NA

NA

111.

S

NA

NA

NA

112.

Superficial parotidectomy

NA

NA

NA

113.

Tumor resection

D

12

DC

114.

S, R, I

Fav

115.

R, I

D

2

NA

116.

NG

117.

Superficial parotidectomy

NA

NA

NA

118.

NA

NA

NA

NA

119.

Superficial parotidectomy

NA

NA

NA

120.

R, palliative

NA

NA

NA

121.

Complete parotidectomy, R

NA

NA

NA

122.

NG

D

NA

MM

123.

S

NA

NA

NA

124.

Complete parotidectomy, further Tt RBP

Fav

125.

E

NA

NA

NA

126.

E

Fav

NA

NA

127.

Superficial parotidectomy

NA

NA

NA

128.

S, R

Fav

129.

NA

NA

NA

NA

130.

NA

NA

NA

NA

131.

S, R

D

5

NA

132.

NA

NA

NA

NA

133.

E, I

NA

NA

NA

134.

S

NA

NA

NA

135.

S, R

D

12

NA

136.

S, C

D

9

MM

137.

S, palliative

NA

NA

NA

138.

Superficial parotidectomy

Fav

NA

NA

139.

R

D

12

NA

140.

Palliative

D

3

NA

141.

Superficial parotidectomy

NA

NA

NA

142.

S

Fav

143.

Palliative

D

2

NA

144.

Palliative radiotherapy

Fav

145.

S

D

24

NA

146.

S

D

3

NA

147.

Complete parotidectomy, R, C

Fav

148.

Embolization

D

NA

RF

149.

S

D

5

NA

150.

S, R

Fav

151.

Superficial parotidectomy

NA

NA

NA

152.

Complete parotidectomy

Fav

153.

Cryosurgery

D

12

NA

154.

S, R, I

NA

NA

NA

155.

Superficial parotidectomy

Fav

156.

S, R

Fav

157.

Brachytherapy

D

5

MM

158.

I

NA

NA

NA

159.

R

NA

NA

NA

160.

S

Fav

161.

IL

UFU

162.

S

Fav

163.

Complete parotidectomy, further Tt refused by patient

NA

NA

NA

164.

NA

NA

NA

NA

165.

S

NA

NA

NA

166.

S, C

UFU

167.

C, R, conservative

UFU

168.

Parotidectomy with preservation of FN, R

UFU

169.

Parotidectomy (partial), nephrectomy, sunitinib

Fav

170.

S, C

TGO

171.

S, R

Fav

172.

Complete parotidectomy, adrenalectomy, nephrectomy

Fav

173.

Systematic

NA (size increased)

174.

I

NA

NA

NA

175.

Total parotidectomy sacrificing FN, RND, and hemithyroidectomy with isthmectomy

NA

176.

S, C, R

UFU

177.

Superficial parotidectomy

Fav

178.

S

NA

NA

NA

179.

NA

NA

NA

NA

180.

Superficial parotidectomy

Fav

181.

R, TKI

Fav

182.

NA

NA

NA

NA

183.

S, I

NA

184.

NA

NA

NA

NA

185.

R, TKI, S

Fav

186.

Palliative radiotherapy

NA

NA

NA

187.

Complete parotidectomy

NA

NA

NA

188.

Complete parotidectomy

NA

NA

NA

189.

NA

NA

NA

NA

190.

Tumor resection

NA

NA

NA

191.

Superficial parotidectomy

NA

NA

NA

192.

Complete parotidectomy

NA

NA

NA

193.

Tumor resection

NA

NA

NA

194.

Complete parotidectomy

NA

NA

NA

195.

Tumor resection

NA

NA

NA

196.

R, S

Fav

197.

Complete parotidectomy

NA

NA

NA

198.

NA

NA

NA

NA

199.

NA

D

6

NA

200.

Sunitinib (targetoid)

TGO

201.

C

NA

NA

NA

202.

R, TKI

D

1

MM

203.

S, R

Fav

204.

S

D

3

NA

205.

Planned for S, C, (NG)

NA

NA

NA

206.

Systemic

D

10 d

Hemorrhage

207.

NA

NA

NA

NA

208.

S, R, C

D

6

MM

209.

Parotidectomy with preservation of FN

NA

NA

NA

210.

Parotidectomy

Fav

211.

Symptomatic therapy

NA

NA

NA

212.

S, R

Fav

213.

S, R, C, TKI

NA

NA

NA

214.

C, conservative

Fav

215.

S

Fav

216.

S, R

D

8

MM

217.

RTO

NA

NA

NA

218.

Systematic

Fav

219.

Palliative R

D

21 d

NA

220.

Tonsillectomy

NA

NA

NA

221.

C, R

Fav

222.

E, palliative radiotherapy

TGO

223.

C, R

D

4

NA

224.

Partial parotidectomy

UFU

225.

Planned for R, C

D

12

NA

226.

Palliative

D

20 d

NA

227.

RBP

D

12

NA

228.

S, C, R

D

6

NA

229.

S

Fav

230.

S

Fav

231.

E, RTO

D

NA

NA

232.

RTO

UFU

233.

Systematic

Fav

234.

RTO

UFU

235.

CT, C

D

1

NA

236.

E

Fav

237.

Targetoid therapy

NA

NA

NA

238.

NA

NA

NA

NA

239.

Parotidectomy

Fav

240.

Parotidectomy

NA

NA

NA

241.

Radical excision of gland

Fav/TGO

242.

Radical excision of gland

Fav/TGO

243.

S

Fav

244.

Lost to follow-up

245.

E

D

15

NA

246.

Nephrectomy

TGO

247.

R, systematic

UFU

248.

T, R

TGO

249.

Targetoid

UFU

Fav/Alive

250.

E, R, palliative immunotherapy

Fav, UFU

Abbreviations: C, chemotherapy; CT, cryotherapy; D, death; d, days; DC, deteriorated condition; DOM, diagnosis of metastasis; E, excision; Fav, favorable; I, interferon; IL, interleukin; MM, multiple metastasis; NA, not available; NG, not given; RBP, refused by patient; RF, respiratory failure; RTO, referred to oncologist; S, surgery; TGO, treatment going on; Tt, treatment; UFU, under follow-up.



#
#

Results

Our research strategy revealed a total of 226 relevant articles.[11] [12] [13] [14] [15] [16] [17] [18] [19] [20] [21] [22] [23] [24] [25] [26] [27] [28] [29] [30] [31] [32] [33] The results of the current research were expressed in descriptive statistics. A total of 250 patients were included with 168 males and 67 females with a male to female ratio of 2.5:1. The maximum number of cases were from the United States (n = 54) followed by Japan (n = 28), United Kingdom (n = 22), Turkey (n = 18), Italy (n = 17), India = Poland (n = 16), and Spain (n = 14). The patients' average age was 62.7 years (range: 18–97). Mean age was 62.4 years in males and 63.7 years in Females. Of the 250 patients, 126 (50.4%) had a previous history of RCC, while 79 had none (31.6%). The most predominant site of OSTM was salivary glands (39.2%) followed by tongue (27.2%) and gingiva (16%). OST was the initial site of metastasis in 31.2% of individuals, the only site of metastasis in 57.2% of cases, whereas 24.8% of cases involved other distant sites too. The most common type of RCC diagnosed was clear cell carcinoma (CCC). Major therapeutic aids included were surgery (41.2%) and combined therapies (22%) ([Table 4]). Twenty-three percent of patients died with a mean survival rate of 10 days to 4 years.

Table 4

Summary of results documented from literature research describing the characteristics of renal cell carcinoma metastasizing to the oral soft tissues (1911–2022)

Feature

Number

Total number of articles published

226

• Case reports—198

• Case series—9

• Retrospective analysis—8

• Original research—3

• Clinicopathological study—3

• Systematic reviews—2

• Correspondences—2

• Prospective study—1

Total number of patients

250

World-wide distribution of cases

• USA—54 (21.6%)

• Japan—28 (11.2%)

• UK—22 (8.8%)

• Turkey—18 (7.2%)

• Italy—17 (6.8%)

• India = Poland—16 (6.4%)

• Spain—14 (5.6%)

• Germany—9 (3.6%)

• Europe—7 (2.8%)

• Brazil—6 (2.4%)

• France—5 (2%)

• Australia = Finland = Greece = Iran—4 (1.6%)

• China—3 (1.2%)

• Israel = Saudi Arabia—2 (0.8%)

• Africa = Argentina = Chile = Czech Republic = Jordan = Morocco = the Netherland = Ireland = Romania = Russia = Sri Lanka = Sudan = South Korea = Canada = Taiwan—1 (0.4%)

Gender

• M—168 (67.2%)

• F—67 (26.8%)

• NA—15 (6%)

M:F = 2.5:1

Average age of patients (range)

• Total—62.7 y (18–97 y)

• Males—62.4 y (27–86 y)

• Females—63.7 y (18–97 y)

Previous history of RCC

• Yes—126 (50.4%)

 R—35 (27.7%)

 L—48 (38.1%)

 NA—43 (34.1%)

• No—79 (31.6%)

• NA—45 (18%)

Associated risk factors

• Yes—114 (45.6%)

• No—85 (34%)

• NA—51 (20.4%)

• Hypertension—14 (12.3%)

• Smoking—12 (10.5%)

• Renal = other malignancies—7 (6.1%)

• Alcohol = cardiac = DM = respiratory—4 (3.5%)

• MM—3 (2.6%)

• Tobacco = anemia = thyroid = prostate—2 (1.7%)

• Areca nut = HOE = FNP = family history of RCC = recurrent RCC—1 (0.8%)

• Others—10 (8.8%)

Site of oral metastasis

• Salivary glands—98 (39.2%)

 o Parotid—84 (85.7%)

  (R—36, L—32, BL—3, SNA—13)

 o Submandibular—12 (12.2%)

  (L—4, R—6, BL—0, SNA—2)

 o Minor glands retromolar—1 (1%)

 o Wharton duct—1 (1%)

• Tongue—68 (27.2%)

 (base—12, dorsum—9, tip—6, ant—3, post—2, L—6, R—6, body—1, SNA—23)

• Gingiva—40 (16%)

 (maxillary—15, mandibular—12, SNA—13)

 o Maxillary—(ant—6, post—1, SNA—8)

  (R—2, L—3, both—3, SNA—7)

 o Mandibular (ant—3, post—4, both—2, SNA—3)

  (R—3, L—2, both—2, SNA—5)

• Lip—12 (4.8%)

 (upper—5, lower—6, SNA—1)

• Buccal mucosa—11 (4.4%)

 (R—2, L—7, NA—2)

• Hard palate—8 (3.2%)

• Palatine tonsils—6 (2.4%)

• Uvula—3 (1.2%)

• Chin—3 (1.2%)

• Soft palate—2 (0.8%)

• Retromolar region—1 (0.4%)

• Facial skin—1 (0.4%)

• Cheek—1 (0.4%)

• SNA—1 (0.4%)

Oral soft tissues as the initial site of metastasis

• Yes—78 (31.2%)

• No—128 (51.2%)

• Detected at the same time—1 (0.4%)

• NA—43 (17.2%)

Any other site of metastasis

• Yes—62 (24.8%)

• No—143 (57.2%)

• NA—45 (18%)

Average time of detection of metastasis after history of nephrectomy

3 weeks to 26 years

Type of RCC

• CCC—241 (96.4%)

• Papillary carcinoma—1 (0.4%)

• Collecting duct carcinoma—1 (0.4%)

• TCC of renal pelvis—1 (0.4%)

• NA—6 (2.4%)

Treatment aids

• Surgical aids—103 (41.2%)

 (parotidectomy—48, not specified—43, excision—8, tumor resection—6)

• Combined therapy—55 (22%)

• Radiotherapy—5 (2%)

• Systematic—5 (2%)

• Interferon—3 (1.2%)

• Palliative radiotherapy—3 (1.2%)

• Palliative treatment—3 (1.2%)

• Symptomatic—2 (0.8%)

• Targetoid therapy—2 (0.8%)

• Chemotherapy—1 (0.4%)

• Cryotherapy—1 (0.4%)

• Cryosurgery—1 (0.4%)

• Brachytherapy—1 (0.4%)

• Interleukins—1 (0.4%)

• Embolization—1 (0.4%)

• Refused by patient—1 (0.4%)

• Referred to oncologist—4 (1.6%)

• Tt planned but died before—1 (0.4%)

• Tt planned but further information NA—1 (0.4%)

• NA—50 (20%)

• NG—6 (2.4%)

Prognosis

• Deaths—57 (23%)

• Favorable—48 (19%)

• UFU—11 (4.4%)

• TGO—7 (2.8%)

• LFU—1 (0.4%)

• NA—125 (50%)

Average time of death from diagnosis of oral metastasis

10 days to 4 years

Abbreviations: Ant, anterior; BL, bilateral; DM, diabetic mellitus; F, female; HOE, history of extraction; L, left; LFU, lost to follow-up; M, male; MM, multiple metastasis; NA, not available; NG, not given; post, posterior; R, right; RBP, refused by patient; RCC, renal cell carcinoma; SNA, site not available; TGO, treatment going on; Tt, treatment; UFU, under follow-up; Y, yes; y, years.



#

Discussion

Metastasis to the oral cavity is a rare occurrence, with the real incidence unclear (1–2% of all oral cancers). Because of their rarity, they are often overlooked for a long time before being discovered and are diagnosed during investigations. RCC is the third most common tumor metastasizing to oral cavity after lung, and liver cancer.[34] In the current research, we found 250 cases of primary RCC metastasizing to OST.

RCC is the most common solid renal tumor originating from the proximal renal tubular epithelium. Worldwide, 403,000 new cases of RCC and 175,000 deaths due to this malignancy were recorded in 2018. In India, the incidence of RCC among males is about 2/100,000 population and among females is about 1/100,000 population.[35] RCC has rapidly become more common in the developed world over the past decades,[36] more than doubling in incidence in the United States since 1975. In our research also, the maximum number of cases were from the United States followed by Japan, United Kingdom, Turkey, India, Spain, Poland, and Europe ([Table 4]).

RCC occurs predominantly during fifth to sixth decades exhibiting a male predilection with a male:female ratio of 1.5:1. In the current study also, there was a male predominance, with a male:female ratio = 2.5:1. However, the age ranged between first and ninth decades.

Multiple risk factors favor the development of RCC which include smoking, tobacco chewing, alcohol, obesity, hypertension, cardiac, liver and renal diseases, urinary stones, diabetes, drug usage, and malnutrition.[2] Studies have reported that cigarette smoke contains many carcinogens as well as the highly addictive substance called nicotine. As they are filtered through the nephron, these particles are metabolized and promote inflammation and induce DNA damage, paving the way for carcinogenesis. Smokers are known to exhibit more risk of RCC than non-smokers.[37] However, in the current research, only 10.5% of cases have revealed the habit of smoking. Many had variable comorbidities, including renal, cardiac, and endocrinal diseases, and history of other malignancies. One patient revealed the family history of RCC.

Pathogenic mechanisms of metastasis to the OST are not completely recognized. Route of secondary metastasis may be hematogenous, lymphatic, or direct invasion. Metastatic RCC spreads predominantly following the hematogenous route. One of the proposed pathways is via Batson's valve plexus system. Angiogenesis plays a crucial role in the development of tumor metastasis. The tumor-derived micro vesicles break off from the primary site. These micro vesicles appear to carry a cancer stem cell phenotype and microRNAs which stimulate angiogenesis.[4] RCC is naturally a pre-angiogenetic cancer. It is hypothesized that the kidneys receive about 25% of the circulating blood volume per minute, in addition to the release of vascular endothelial growth factor and other angiogenic factors by RCC, resulting in the hypervascularity of these tumors and their association with arteriovenous shunts contributing to the unique hematogenous route of spread. Majority of cases of RCC involve dysfunction of Von–Hippel–Lindau gene which promotes ubiquitination and inactivation of hypoxia-induced factor in healthy individuals which creates a pre-angiogenic environment.[4]

The OST has a rich capillary network, and the uneven basement membrane of proliferating capillaries may allow malignant cells to penetrate the tissues more easily.

The most common site of OSTM is the attached gingiva (57%), followed by the tongue (27%), tonsil (8%), palate (4%), lip (3%), buccal mucosa (BM) (1%), and floor of mouth (<1%).[9] OSTM of the RCC mostly affects tongue, gingiva, and parotid glands.[5] In the current study, the majority of RCC metastasis to OST were found in salivary glands (39.2%), tongue (27.2%), gingiva (16%), lip (4.8%), BM (4.4%), HP (3.2%), palatine tonsils (2.4%), uvula (1.2%), soft palate (SP) (0.8%), and in the retromolar region = minor glands = Wharton duct = facial skin = cheek (0.4%). And the results were compared with the previous reviews ([Table 5]). Malignant neoplasms of the salivary glands are very rare with 1 to 4% occurrence and the parotid gland being the most affected. Approximately 0.1% of all salivary gland metastatic neoplasms exhibit a primary focus to be RCC. In parotid, RCC metastasis is mainly through hematogenous route due to high vascularity of these lesions. Udager and Rungta and Lieder et al published a review of the literature reporting 36 and 45 cases of RCC parotid metastasis.[12] [13] In our research, 98 of 250 cases involved the salivary glands, with maximum instances involving the parotid (84/240). SMG involved only 12 cases. None of the cases involved sublingual gland. One case affected solely the Wharton duct. While in another case, only minor salivary glands of retromolar region were involved. The tongue is a highly circulatory organ, which creates ideal conditions for the spread of cancer. Posterolateral and dorsal part are more often involved in metastasis due to rich capillary and lymphatic network and immobility. Irani in 2016 documented that in 19 of 58 cases of RCC, metastatic site was the tongue.[5] In the current research, 67 of 250 cases of metastatic RCC involved the tongue, maximally affecting the base with 12 cases followed by dorsum, tip, and lateral border. Chronically, inflamed mucosa of gingiva, particularly the attached gingiva, contains a dense capillary network that can trap malignant cells and promote metastases. In the current research, gingiva was the third most common site of RCC metastasis (16% cases). Studies conclude that gingival metastasis mostly occurs in mandibular area than in maxillary with predominancy of posterior side involvement.[5] [6] [7] [8] In the current research, however, there was maxillary predilection. Anterior region was mostly affected in maxilla, whereas there was almost equal involvement of anterior and posterior sides in mandible. The extraction site of tooth is thought to be a microenvironment rich in local growth factors that encourage metastatic cell development.[5] In our research, one peculiar case of post-extraction site metastasis has been observed in which patient approached with a complaint of painful growth in the region of extracted tooth after 7 days. Lip, BM, HP, SP, uvula, and tonsils are the rare sites of OSTM from distant resources. Few cases of lip metastasis have been reported from colon and gastric cancers. In the present review, only 12 cases of lip and 11 cases of BM from RCC were notified. The most common malignant neoplasms of the palatal mucosa are known to be minor salivary gland tumors and metastatic tumor from a distant organ in this region is uncommon.[38] In the present research, only 13 cases were found in the palate region. According to a research, only 0.8% of malignant palatine tonsillar tumours was from an extra-tonsillar source.[39] Lymphatic spread to tonsils is rare due to lack of afferent lymphatic capillaries except retrograde spread via cervical lymph nodes or direct spread; thus, metastatic pathway is unclear. In the current literature, only six cases of palatine tonsillar metastasis from RCC have been observed.

Table 5

Comparison of sites of oral soft tissues metastasis from renal cell carcinoma with the previous reviews conducted in the literature

Author, year

Sujonin et al, 2014

Vasilyeva et al, 2017

Kovalski et al, 2020

Nisi et al, 2020

Current study, 2022

Duration

1975–2014

2007–2017

(2010–2019)

(1911–2020)

(1911–2022)

Oral sites affected (number)

• P—10

• T—8

• OM—6

• To, facial muscles, oropharynx—9

• T—12

• G—8

• L—2

• HP—1

• SP—1

• BM—1

• T—11

• G—8

• SMG—2

• P—8

• L—2

• BM—1

• Cheek—2

• T—56

• G—26

• L—6

• HP—4

• SP—1

• BM—1

• P—84

• T—68

• G—40

• L—12

• BM—11

• SMG—12

• HP—8

• To—6

• Uvula—3

• SP—2

• Chin—2

• Retromolar—1

• Minor glands—1

• Wharton duct—1

• Facial skin—1

Reference no.

[11]

[14]

[18]

[19]

Abbreviations: BM, buccal mucosa; G, gingiva; HP, hard palate; L, lip; P, parotid; SMG, submandibular gland; SP, soft palate; T, tongue; To, tonsils.


Oral metastatic tumours are of high clinical importance because they may be the only symptom of an undiagnosed underlying malignancy or the first sign of the metastasis. In our study, 31.2% cases of OSTM from RCC presented as the initial site of metastasis, whereas in 51.2% cases, metastasis was detected after the nephrectomy done for RCC, with an average time of 3 weeks to 26 years. The clinical aspects of kidney metastasis in the OST vary according to the anatomical site involved characterized by rapidly growing painful or asymptomatic swellings that bleed easily, difficulty in chewing, and dysphagia. One of the characteristic features of metastatic RCC is their intense vascularization. These metastatic lesions often become difficult to diagnose because their variable appearances bear close resemblance to some benign hyperplastic or reactive oral lesions. In the present research, rapidly increasing vascular swelling was the most predominant clinical feature observed. Other lesions appeared as ulcerative, exophytic, pedunculated, nodular, and edematous. A history of primary tumor could help in the detection of secondary metastatic deposits. Before the metastatic spread to the oral cavity, the majority of patients are aware of their primary tumours. However, metastasis to OST via RCC is a late indication. In the current research, 50.4% of patients had a previous history of primary RCC with nephrectomy; 31.6% of patients did not reveal such history.

Histopathological examination is required to provide a conclusive diagnosis of the type of metastatic lesion. However, it might be difficult to make an exact diagnosis because of varied histological appearance, particularly when the major focus of primary site is unknown. Other tools, such as special staining, immunohistochemistry, and electron microscopy, may be necessary in some circumstances to determine the initial tumor's nature. Histopathologically, RCC has been divided into various subgroups. The World Health Organization classification of urogenital tumors in 2022 have introduced many new entities in the RCC.[40] CCC is the most predominant type and has been discovered to be the most prevalent metastasizing to the OST. The finding was same in this study as well. 96.4% cases were diagnosed to be CCC. Although RCC entails multiorgan distant metastases, OST might occasionally be the only site of metastasis. Out of 250 instances in this study, 143 had OST as the only location of RCC metastasis, whereas 62 had metastasis to other regions as well, such as lungs, brain, adrenals, liver, vertebrae, spine, pelvis, skin, and skeletal muscles.

Treatment options for metastatic RCC include biopsy, surgery, chemotherapy, radiotherapy, brachytherapy, and/or combination therapy. The most commonly used therapeutic aids in this study were surgical aids (41.2%) and combination therapy (22%). Salivary gland lesions were treated by parotidectomy, superficial, deep, partial, or total depending on the site. Unfortunately, OSTM by RCC has a bad prognosis with a maximum survival rate of approximately 5 years. In some cases, a patient's terminal stage of disease results in a loss of follow-up or death. Even after treatment, 57 people died, according to the current study with a survival time of 10 days to 4 years. Multiple metastases, deteriorated systemic condition, hepatic insufficiency, and uncontrolled bleeding were the most common causes of death. Forty-eight patients had a good prognosis with no signs of recurrence. In seven patients, treatment is going on. Eleven cases are under follow-up.


#

Limitations of the Current Study

One of the limitations of current research was small sample size. Most of the included studies were case reports and case series. And in many of the included studies, individual data of patients were not available.


#

Conclusions

During the last 111 years (1911–2022), we found only 250 cases of OSTM from RCC as the sole primary source. This signifies a rare occurrence of OSTM from RCC. The prognosis was poor involving 23% deaths with a survival rate of few days to 4 years. Parotid, tongue, and gingiva were the most prevalent sites to get metastasized. Because of their resemblance to other pathologies, and late clinical signs, these lesions go unnoticed the majority of the time. Diagnosis of oral metastatic lesions is a challenging task for the clinicians and pathologists. A thorough examination of the metastatic lesions is required, including a review of the patient's medical history, clinical presentation, and early diagnosis in order to identify the primary site of metastasis and choose the best course of treatment.


#
#

Conflict of Interest

None declared.

Abbreviations

BM: Buccal mucosa, CCC: Clear cell carcinoma, HP: Hard palate, LC: Lung cancer, NA: Not available, OST: Oral soft tissues, OSTM: Oral soft tissue metastasis, RCC: Renal cell carcinoma, SMG: Submandibular gland, SP: Soft palate.


Ethical Approval

Not required.


Ethical Approval and Consent to Participate

Not applicable.


Consent for Publication

Not applicable.


Availability of Data and Material

Electronic research.


Competing Interests

None.


Authors' Contributions

• S.G., H.V.P.: Conceptualization, data curation, investigation, methodology, project administration, resources, validation, writing—original draft, writing—review and editing, supervision.


• R.V., H.S., J.K., J.K.: Investigation, methodology, project administration, validation.


  • References

  • 1 Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68 (06) 394-424
  • 2 Padala SA, Barsouk A, Thandra KC. et al. Epidemiology of renal cell carcinoma. World J Oncol 2020; 11 (03) 79-87
  • 3 Brufau BP, Cerqueda CS, Villalba LB, Izquierdo RS, González BM, Molina CN. Metastatic renal cell carcinoma: radiologic findings and assessment of response to targeted antiangiogenic therapy by using multidetector CT. Radiographics 2013; 33 (06) 1691-1716
  • 4 Gong J, Maia MC, Dizman N, Govindarajan A, Pal SK. Metastasis in renal cell carcinoma: biology and implications for therapy. Asian J Urol 2016; 3 (04) 286-292
  • 5 Irani S. Metastasis to the oral soft tissues: a review of 412 cases. J Int Soc Prev Community Dent 2016; 6 (05) 393-401
  • 6 Hirshberg A, Shnaiderman-Shapiro A, Kaplan I, Berger R. Metastatic tumours to the oral cavity - pathogenesis and analysis of 673 cases. Oral Oncol 2008; 44 (08) 743-752
  • 7 Servato JP, de Paulo LF, de Faria PR, Cardoso SV, Loyola AM. Metastatic tumours to the head and neck: retrospective analysis from a Brazilian tertiary referral centre. Int J Oral Maxillofac Implants 2013; 42 (11) 1391-1396
  • 8 Hirshberg A, Berger R, Allon I, Kaplan I. Metastatic tumors to the jaws and mouth. Head Neck Pathol 2014; 8 (04) 463-474
  • 9 Riley DS, Barber MS, Kienle GS. et al. CARE guidelines for case reports: explanation and elaboration document. J Clin Epidemiol 2017; 89: 218-235
  • 10 von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. STROBE Initiative. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 2008; 61 (04) 344-349
  • 11 Suojanen J, Färkkilä E, Helkamaa T. et al. Rapidly growing and ulcerating metastatic renal cell carcinoma of the lower lip: a case report and review of the literature. Oncol Lett 2014; 8 (05) 2175-2178
  • 12 Udager AM, Rungta SA. Metastatic renal cell carcinoma, clear cell type, of the parotid gland: a case report, review of literature, and proposed algorithmic approach to salivary gland clear cell neoplasms in fine-needle aspiration biopsies. Diagn Cytopathol 2014; 42 (11) 974-983
  • 13 Lieder A, Guenzel T, Lebentrau S, Schneider C, Franzen A. Diagnostic relevance of metastatic renal cell carcinoma in the head and neck: an evaluation of 22 cases in 671 patients. Int Braz J Urol 2017; 43 (02) 202-208
  • 14 Vasilyeva D, Peters SM, Philipone EM, Yoon AJ. Renal cell carcinoma metastatic to the maxillary gingiva: a case report and review of the literature. J Oral Maxillofac Pathol 2018; 22 (Suppl. 01) S102-S107
  • 15 Sydney G, Ioakim K, Kara N, George Pantelas G. Rare case of clear cell renal cell carcinoma metastasizing to contralateral kidney and ipsilateral parotid more than five years following nephrectomy. Balk J Dent Med 2019; 23: 108-111
  • 16 Fejsa Levakov A, Amidžic J, Ilić Sabo J, Lakić T, Vojinov S, Grbić D. Unusual site for metastatic renal cell carcinoma – a case report. Vojnosanit Pregl 2020; 7: 233-236
  • 17 Halbony H, Albrezat M, Hmaid D, Albsoul N. Parotid gland metastasis as an initial presentation of renal cell carcinoma: a case report. Med J Islam Repub Iran 2020; 34: 175
  • 18 Kovalski LNS, Ribeiro JT, Martins MD. et al. A rare case of oral metastasis of renal clear cell carcinoma: case report and review of literature. J. Oral Diag. 2020; 05: e20200006
  • 19 Nisi M, Izzetti R, Graziani F, Gabriele M. Renal cell carcinoma metastases to the oral cavity: report of 2 cases and review of literature. J Oral Maxillofac Surg 2020; 78 (09) 1557-1571
  • 20 Patel S, Barros J, Nwizu NN, Ogbureke KUE. Metastatic renal cell carcinoma to the oral cavity as first sign of disease: a case report. Clin Case Rep 2020; 8 (08) 1517-1521
  • 21 Stojanović M, Krasić D, Trajković M, Petrović V. Rare renal cell carcinoma metastasis to mandibular gingiva: a case report and literature review. Niger J Clin Pract 2020; 23 (10) 1483-1486
  • 22 Cecen A, Kavaz E, Gun S. A rare case: renal cell carcinoma metastasis to lower lip. J Exp Clin Med 2021; 38: 396-397
  • 23 Chelliah P, Shah KM, Vandergriff T, Nijhawan RI. Pink nodule of the chin: an unusual presentation of metastatic carcinoma. Dermatol Online J 2021; 27 (08) 2-5
  • 24 Darshan DP, Rahul A, Umank BT. Unusual site of metastasis in a case of renal cell carcinoma - a case report. Guj Canc Soc Res J 2021; 1: 25-27
  • 25 Gopan G, Kamala LH, Radhakrishnan N. Renal cell carcinoma presenting as bulky parotid mass - a case report and review of literature. Indian J Surg Oncol 2021; 12 (Suppl. 02) 378-382
  • 26 Martire MB, Villena LF, Sousa Jr JA, Montoro JRM, Uvo SAB. Parotid metastasis of clear-cell renal cell carcinoma (ccRCC): a case report. Arch Head Neck Surg. 2021; 50: e20215016
  • 27 Santana T, Custódio M, Dayla Melo Oliveira C, Dos Santos Antunes E, Cantanhede Orsini Machado de Sousa S, Daumas Nunes F. Parotid metastasis of clear cell renal cell carcinoma 8 years after nephrectomy. Oral Oncol 2021; 122: 105561
  • 28 Villanueva F, Fonseca D, Rojas C. Escalante l. Granulomatous lesion in inserted gum-metastasis of renal clear. ODOVTOS-Int J Dental Sc 2021; 23–1: 43-52
  • 29 Williams J, Depcik-Smith N, Williams T, Feldman SR. Metastatic renal clear cell carcinoma masquerading as a pyogenic granuloma on the lip. Dermatol Online J 2021; 27 (11) 1-6
  • 30 Baez FS, Collazo P. Oral metastasis of renal cell carcinoma. A case report and literature review. Odontoestomatologia 2022; 24: 1-7
  • 31 Lavanya ML, Iyer PJM, Vijayakumar R. Buccal mucosal metastasis of renal cell carcinoma: a case report and review of literature. International Journal of Clinical Research 2022; 3: 132-137
  • 32 Singla A, Sharma U, Makkar A. et al. Rare metastatic sites of renal cell carcinoma: a case series. Pan Afr Med J 2022; 42: 26
  • 33 Wallace J, Abelardo E, Ramachandran K, Prabhu V. Renal cell carcinoma uvula metastasis leading to airway compromise: an unusual site. BMJ Case Rep 2022; 15 (04) e248098
  • 34 Liu Y, Vargo RJ, Bilodeau EA. Analytic survey of 57 cases of oral metastases. J Oral Pathol Med 2018; 47 (03) 275-280
  • 35 Abraham GP, Cherian T, Mahadevan P, Avinash TS, George D, Manuel E. Detailed study of survival of patients with renal cell carcinoma in India. Indian J Cancer 2016; 53 (04) 572-574
  • 36 Howlander N, Noone AM, Krapcho M. et al. SEER cancer statistics review 1975-2016. Natl. Cancer Institute 2019 . Accessed February 5, 2024 at: https://seer.cancer.gov › csr › 1975_2016
  • 37 Tsivian M, Moreira DM, Caso JR, Mouraviev V, Polascik TJ. Cigarette smoking is associated with advanced renal cell carcinoma. J Clin Oncol 2011; 29 (15) 2027-2031
  • 38 Wyszyńska-Pawelec G, Gontarz M, Zapała J, Szuta M. Minor salivary gland tumours of upper aerodigestive tract: a clinicopathological study. Gastroenterol Res Pract 2012; 2012: 780453
  • 39 Hyams VJ. Differential diagnosis of neoplasia of the palatine tonsil. Clin Otolaryngol Allied Sci 1978; 3 (02) 117-126
  • 40 Moch H, Amin MB, Berney DM. et al. The 2022 World Health Organization Classification of Tumours of the Urinary System and Male Genital Organs - Part A: Renal, penile, and testicular tumours. Eur Urol 2022; 82 (05) 458-468

Address for correspondence

Sonia Gupta, MDS
#95/3, Adarsh Nagar, Dera Bassi, Mohali, Punjab 140507
India   

Publication History

Article published online:
06 May 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68 (06) 394-424
  • 2 Padala SA, Barsouk A, Thandra KC. et al. Epidemiology of renal cell carcinoma. World J Oncol 2020; 11 (03) 79-87
  • 3 Brufau BP, Cerqueda CS, Villalba LB, Izquierdo RS, González BM, Molina CN. Metastatic renal cell carcinoma: radiologic findings and assessment of response to targeted antiangiogenic therapy by using multidetector CT. Radiographics 2013; 33 (06) 1691-1716
  • 4 Gong J, Maia MC, Dizman N, Govindarajan A, Pal SK. Metastasis in renal cell carcinoma: biology and implications for therapy. Asian J Urol 2016; 3 (04) 286-292
  • 5 Irani S. Metastasis to the oral soft tissues: a review of 412 cases. J Int Soc Prev Community Dent 2016; 6 (05) 393-401
  • 6 Hirshberg A, Shnaiderman-Shapiro A, Kaplan I, Berger R. Metastatic tumours to the oral cavity - pathogenesis and analysis of 673 cases. Oral Oncol 2008; 44 (08) 743-752
  • 7 Servato JP, de Paulo LF, de Faria PR, Cardoso SV, Loyola AM. Metastatic tumours to the head and neck: retrospective analysis from a Brazilian tertiary referral centre. Int J Oral Maxillofac Implants 2013; 42 (11) 1391-1396
  • 8 Hirshberg A, Berger R, Allon I, Kaplan I. Metastatic tumors to the jaws and mouth. Head Neck Pathol 2014; 8 (04) 463-474
  • 9 Riley DS, Barber MS, Kienle GS. et al. CARE guidelines for case reports: explanation and elaboration document. J Clin Epidemiol 2017; 89: 218-235
  • 10 von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. STROBE Initiative. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 2008; 61 (04) 344-349
  • 11 Suojanen J, Färkkilä E, Helkamaa T. et al. Rapidly growing and ulcerating metastatic renal cell carcinoma of the lower lip: a case report and review of the literature. Oncol Lett 2014; 8 (05) 2175-2178
  • 12 Udager AM, Rungta SA. Metastatic renal cell carcinoma, clear cell type, of the parotid gland: a case report, review of literature, and proposed algorithmic approach to salivary gland clear cell neoplasms in fine-needle aspiration biopsies. Diagn Cytopathol 2014; 42 (11) 974-983
  • 13 Lieder A, Guenzel T, Lebentrau S, Schneider C, Franzen A. Diagnostic relevance of metastatic renal cell carcinoma in the head and neck: an evaluation of 22 cases in 671 patients. Int Braz J Urol 2017; 43 (02) 202-208
  • 14 Vasilyeva D, Peters SM, Philipone EM, Yoon AJ. Renal cell carcinoma metastatic to the maxillary gingiva: a case report and review of the literature. J Oral Maxillofac Pathol 2018; 22 (Suppl. 01) S102-S107
  • 15 Sydney G, Ioakim K, Kara N, George Pantelas G. Rare case of clear cell renal cell carcinoma metastasizing to contralateral kidney and ipsilateral parotid more than five years following nephrectomy. Balk J Dent Med 2019; 23: 108-111
  • 16 Fejsa Levakov A, Amidžic J, Ilić Sabo J, Lakić T, Vojinov S, Grbić D. Unusual site for metastatic renal cell carcinoma – a case report. Vojnosanit Pregl 2020; 7: 233-236
  • 17 Halbony H, Albrezat M, Hmaid D, Albsoul N. Parotid gland metastasis as an initial presentation of renal cell carcinoma: a case report. Med J Islam Repub Iran 2020; 34: 175
  • 18 Kovalski LNS, Ribeiro JT, Martins MD. et al. A rare case of oral metastasis of renal clear cell carcinoma: case report and review of literature. J. Oral Diag. 2020; 05: e20200006
  • 19 Nisi M, Izzetti R, Graziani F, Gabriele M. Renal cell carcinoma metastases to the oral cavity: report of 2 cases and review of literature. J Oral Maxillofac Surg 2020; 78 (09) 1557-1571
  • 20 Patel S, Barros J, Nwizu NN, Ogbureke KUE. Metastatic renal cell carcinoma to the oral cavity as first sign of disease: a case report. Clin Case Rep 2020; 8 (08) 1517-1521
  • 21 Stojanović M, Krasić D, Trajković M, Petrović V. Rare renal cell carcinoma metastasis to mandibular gingiva: a case report and literature review. Niger J Clin Pract 2020; 23 (10) 1483-1486
  • 22 Cecen A, Kavaz E, Gun S. A rare case: renal cell carcinoma metastasis to lower lip. J Exp Clin Med 2021; 38: 396-397
  • 23 Chelliah P, Shah KM, Vandergriff T, Nijhawan RI. Pink nodule of the chin: an unusual presentation of metastatic carcinoma. Dermatol Online J 2021; 27 (08) 2-5
  • 24 Darshan DP, Rahul A, Umank BT. Unusual site of metastasis in a case of renal cell carcinoma - a case report. Guj Canc Soc Res J 2021; 1: 25-27
  • 25 Gopan G, Kamala LH, Radhakrishnan N. Renal cell carcinoma presenting as bulky parotid mass - a case report and review of literature. Indian J Surg Oncol 2021; 12 (Suppl. 02) 378-382
  • 26 Martire MB, Villena LF, Sousa Jr JA, Montoro JRM, Uvo SAB. Parotid metastasis of clear-cell renal cell carcinoma (ccRCC): a case report. Arch Head Neck Surg. 2021; 50: e20215016
  • 27 Santana T, Custódio M, Dayla Melo Oliveira C, Dos Santos Antunes E, Cantanhede Orsini Machado de Sousa S, Daumas Nunes F. Parotid metastasis of clear cell renal cell carcinoma 8 years after nephrectomy. Oral Oncol 2021; 122: 105561
  • 28 Villanueva F, Fonseca D, Rojas C. Escalante l. Granulomatous lesion in inserted gum-metastasis of renal clear. ODOVTOS-Int J Dental Sc 2021; 23–1: 43-52
  • 29 Williams J, Depcik-Smith N, Williams T, Feldman SR. Metastatic renal clear cell carcinoma masquerading as a pyogenic granuloma on the lip. Dermatol Online J 2021; 27 (11) 1-6
  • 30 Baez FS, Collazo P. Oral metastasis of renal cell carcinoma. A case report and literature review. Odontoestomatologia 2022; 24: 1-7
  • 31 Lavanya ML, Iyer PJM, Vijayakumar R. Buccal mucosal metastasis of renal cell carcinoma: a case report and review of literature. International Journal of Clinical Research 2022; 3: 132-137
  • 32 Singla A, Sharma U, Makkar A. et al. Rare metastatic sites of renal cell carcinoma: a case series. Pan Afr Med J 2022; 42: 26
  • 33 Wallace J, Abelardo E, Ramachandran K, Prabhu V. Renal cell carcinoma uvula metastasis leading to airway compromise: an unusual site. BMJ Case Rep 2022; 15 (04) e248098
  • 34 Liu Y, Vargo RJ, Bilodeau EA. Analytic survey of 57 cases of oral metastases. J Oral Pathol Med 2018; 47 (03) 275-280
  • 35 Abraham GP, Cherian T, Mahadevan P, Avinash TS, George D, Manuel E. Detailed study of survival of patients with renal cell carcinoma in India. Indian J Cancer 2016; 53 (04) 572-574
  • 36 Howlander N, Noone AM, Krapcho M. et al. SEER cancer statistics review 1975-2016. Natl. Cancer Institute 2019 . Accessed February 5, 2024 at: https://seer.cancer.gov › csr › 1975_2016
  • 37 Tsivian M, Moreira DM, Caso JR, Mouraviev V, Polascik TJ. Cigarette smoking is associated with advanced renal cell carcinoma. J Clin Oncol 2011; 29 (15) 2027-2031
  • 38 Wyszyńska-Pawelec G, Gontarz M, Zapała J, Szuta M. Minor salivary gland tumours of upper aerodigestive tract: a clinicopathological study. Gastroenterol Res Pract 2012; 2012: 780453
  • 39 Hyams VJ. Differential diagnosis of neoplasia of the palatine tonsil. Clin Otolaryngol Allied Sci 1978; 3 (02) 117-126
  • 40 Moch H, Amin MB, Berney DM. et al. The 2022 World Health Organization Classification of Tumours of the Urinary System and Male Genital Organs - Part A: Renal, penile, and testicular tumours. Eur Urol 2022; 82 (05) 458-468

Zoom Image
Fig. 1 PRISMA flowchart showing search strategy.