原発巣と上顎歯肉への転移巣に同時手術を行い長期生存を認めた腎細胞癌の1例

• Published in: 日本口腔外科学会雑誌 Vol. 65; no. 3; pp. 172 - 178
• Main Authors: 齋藤, 大嗣, 阿部, 亮輔, 樋野, 雅文, 八木, 正篤, 水城, 春美, 山田, 浩之
• Format: Journal Article
• Language: Japanese
• Published: 社団法人 日本口腔外科学会 20.03.2019
• Subjects: 上顎; 腎細胞癌; 腹部大動脈瘤; 転移
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.65.172

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