RESUMO
BACKGROUND: Melanoma of the skin is characterised by a high metastatic potential, but reports of metastasis to the tongue are rare. We report a case of skin melanoma with metastasis to the lymph nodes, tongue and brain. OBJECTIVES: This report highlights the clinical and histological features of oral metastatic melanoma. CASE REPORT: A 72-year-old man was seen with a nodule on the tongue. The differential diagnosis included salivary gland tumour, lymphoma and metastatic melanoma. His medical history revealed treatment for melanoma in the periumbilical region and micrometastases in the inguinal lymph nodes. An incisional biopsy was obtained and histological analysis showed the presence of a solid, epithelioid malignant tumour of monotonous appearance infiltrating the skeletal musculature. Immunohistochemistry showed reactivity of neoplastic cells to anti-HMB45, anti-melan A and anti-S100 antibodies and negativity for anti-PAN cytokeratin, confirming the diagnosis of metastatic melanoma. CONCLUSION: The present findings highlight the importance of a complete medical evaluation of the patient by anamnesis to identify possible oral repercussions of primary diseases in other organs and/or systems.
Assuntos
Melanoma/secundário , Neoplasias Cutâneas/patologia , Neoplasias da Língua/secundário , Idoso , Neoplasias Encefálicas/secundário , Diagnóstico Diferencial , Humanos , Imuno-Histoquímica , Metástase Linfática/diagnóstico , Antígeno MART-1/análise , Masculino , Melanoma/patologia , Antígenos Específicos de Melanoma/análise , Proteínas S100/análise , Antígeno gp100 de MelanomaRESUMO
Squamous cell carcinomas (SCCs) account for approximately 95% of all oral malignant neoplasms and for about 38% of all malignant head and neck tumors, especially affecting the tongue and lips. The aim of this study was to evaluate the immunohistochemical expression of MMP-9 and VEGF in oral SCC according to the occurrence of metastasis. Eighteen cases of tongue SCC without metastases and 17 cases of tongue SCC with metastases were subjected to immunohistochemical methods. High immunohistochemical expression of MMP-9 and VEGF by neoplastic cells and stroma was observed in tongue SCCs at the invasion front. Metastatic tumors tended to express higher levels of MMP-9 and VEGF than non-metastatic tumors, but the difference was not significant (P > 0.05). Spearman's correlation test showed no significant correlation between VEGF-immunopositive vessels and metastasis (P > 0.05). The present results demonstrate the importance of the expression of MMP-9 and VEGF for the development of SCC of the tongue. However, no significant association was observed between the overexpression of MMP-9 or VEGF and the presence of metastases.
Assuntos
Carcinoma de Células Escamosas/metabolismo , Metaloproteinase 9 da Matriz/biossíntese , Neoplasias da Língua/metabolismo , Fator A de Crescimento do Endotélio Vascular/biossíntese , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/irrigação sanguínea , Carcinoma de Células Escamosas/secundário , Feminino , Humanos , Técnicas Imunoenzimáticas , Masculino , Metaloproteinase 9 da Matriz/genética , Pessoa de Meia-Idade , Metástase Neoplásica , Neovascularização Patológica , Inclusão em Parafina , Estudos Retrospectivos , Estatísticas não Paramétricas , Células Estromais/metabolismo , Neoplasias da Língua/irrigação sanguínea , Neoplasias da Língua/secundário , Fator A de Crescimento do Endotélio Vascular/genéticaRESUMO
Thyroglossal duct cyst is the most common congenital anomaly of thyroid gland development. However, papillary carcinoma is described only in 1-2% of cases and the clinical appearance is indistinguishable from a benign thyroglossal duct cyst. We report two females aged 15 and 27 years consulting for a cervical mass. In both, a solid cystic lesion was found and excised using the Sistrunk procedure. The biopsy disclosed a papillary carcinoma in both. The postoperative evolution of both patients was uneventful.
Assuntos
Carcinoma Papilar/patologia , Cisto Tireoglosso/patologia , Neoplasias da Glândula Tireoide/patologia , Adolescente , Adulto , Biópsia por Agulha Fina , Carcinoma Papilar/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Metástase Linfática , Neoplasias da Glândula Submandibular/secundário , Neoplasias da Glândula Submandibular/cirurgia , Cisto Tireoglosso/cirurgia , Neoplasias da Glândula Tireoide/cirurgia , Neoplasias da Língua/secundário , Neoplasias da Língua/cirurgiaRESUMO
Thyroglossal duct cyst is the most common congenital anomaly of thyroid gland development. However, papillary carcinoma is described only in 1-2 percent of cases and the clinical appearance is indistinguishable from a benign thyroglossal duct cyst. We report two females aged 15 and 27years consulting for a cervical mass. In both, a solid cystic lesion was found and excised using the Sistrunk procedure. The biopsy disclosed a papillary carcinoma in both. The postoperative evolution of both patients was uneventful.
Assuntos
Adolescente , Adulto , Feminino , Humanos , Carcinoma Papilar/patologia , Cisto Tireoglosso/patologia , Neoplasias da Glândula Tireoide/patologia , Biópsia por Agulha Fina , Carcinoma Papilar/cirurgia , Diagnóstico Diferencial , Metástase Linfática , Neoplasias da Glândula Submandibular/secundário , Neoplasias da Glândula Submandibular/cirurgia , Cisto Tireoglosso/cirurgia , Neoplasias da Glândula Tireoide/cirurgia , Neoplasias da Língua/secundário , Neoplasias da Língua/cirurgiaRESUMO
Metastases from infraclavicular neoplasms to the oral cavity are rare, and the anatomical structures most frequently affected are the maxillae. The primary sites that develop metastases to head and neck include lung, breast, liver, thyroid gland, kidney and melanomas, among others. The breast is one of the usual primary regions that can present them. In the literature, most metastases to these regions correspond to squamous cell carcinomas and adenocarcinomas; few studies report other type of neoplasms such as phyllodes tumour (PT) that present this behaviour. The importance of identifying metastatic disease to the oral cavity, be it as the first manifestation of a neoplasm from unknown origin or as a development in the course of the disease, is that it allows determination of adequate treatment, which has an effect on the patient's prognosis. The usual behaviour of PT is frequent recurrence and, when metastases are present, these are to lungs and bone. Two cases of malignant PT metastasising to tongue and lip are presented, as well as a review of the literature.