title: Metastasis of hepatocellular carcinoma to the supramaxillary gingiva and right ventricle.
abstract: We describe a rare double metastasis of hepatocellular carcinoma to the supramaxillary gingiva and papillary muscle of the right ventricle. The patient was a 72-year-old woman who underwent three sessions of transcatheter arterial embolization for the primary lesions. Control of bleeding from the supramaxillary gingival metastasis was difficult by conservative treatment such as compression with gauze soaked in epinephrine. Therefore, radiotherapy was performed, but it failed to control the bleeding. The patient subsequently died due to hepatic failure. Autopsy revealed metastases of hepatocellular carcinoma to the papillary muscle of the right ventricle and paraaortic lymph node in the abdomen in addition to the supramaxillary gingival metastasis. Histopathological examination showed moderately differentiated hepatocellular carcinoma of both the primary site and metastatic sites to the gingiva and the heart and poorly differentiated in the paraaortic lymph node.
authors.affiliation: First Department of Internal Medicine, Gunma University Faculty of Medicine, Showa, Maebashi, Japan.
authors.forename: Riki
authors.initials: R
authors.lastname: Arai
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Otsuka
authors.forename: Kazuyo
authors.initials: K
authors.lastname: Mori
authors.forename: Ryota
authors.initials: R
authors.lastname: Kobayashi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Tomizawa
authors.forename: Naondo
authors.initials: N
authors.lastname: Sohara
authors.forename: Satoru
authors.initials: S
authors.lastname: Kakizaki
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Hirokawa
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kanda
authors.forename: Hiroko
authors.initials: H
authors.lastname: Nakayama
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakajima
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Takagi
authors.forename: Masatomo
authors.initials: M
authors.lastname: Mori
mesh_terms: D000368:Aged; D000792:Angiography; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000532:radiotherapy / Q000556:secondary*; D017809:Fatal Outcome; D005260:Female; D005887:Gingival Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy / Q000556:secondary*; D006338:Heart Neoplasms / Q000556:secondary*; D006352:Heart Ventricles; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008207:Lymphatic Metastasis; D010210:Papillary Muscles; D014057:Tomography, X-Ray Computed