Oral ulcer as an exclusive sign of gastric cancer: report of a rare case.
BACKGROUND
The oral cavity is a rare but occasional target for metastases, which may masquerade as various benign and inflammatory lesions, and sometimes also be asymptomatic. Oral metastatic lesions have been described in various cancers, particularly lung, breast and kidney carcinoma.


METHODS
We here describe an uncommon case of a hard palate mucosa and gingival metastasis from gastric carcinoma that was originally diagnosed as a periodontal disease. Histopathological examination of a biopsy of the lesion revealed a signet-ring cell carcinoma, and a subsequent biopsy of an ulcerated stomach lesion showed a poorly differentiated gastric carcinoma. The patient underwent gastric resection but died of heart failure on the tenth postoperative day; a post-mortem examination revealed a residual bilateral ovarian infiltration by gastric carcinoma (Krukenberg's tumor).


CONCLUSIONS
An occult carcinoma of the stomach may rarely metastasise to the oral cavity even as a first and exclusive manifestation; it is important to bear this possibility in mind because such conditions may mimic a benign disease.
Colombo
Piergiuseppe
P
Department of Pathology, Istituto Clinico Humanitas, via Manzoni 56, 20089 Rozzano, Milan, Italy. piergiuseppe.colombo@humanitas.it
Tondulli
Luca
L
Masci
Giovanna
G
Muzza
Andrea
A
Rimassa
Lorenza
L
Petrella
Duccio
D
Santoro
Armando
A
D001706:Biopsy; D002277:Carcinoma / Q000473:pathology; D018279:Carcinoma, Signet Ring Cell / Q000175:diagnosis* / Q000473:pathology*; D002454:Cell Differentiation; D017809:Fatal Outcome; D005260:Female; D005887:Gingival Neoplasms / Q000556:secondary*; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009055:Mouth / Q000473:pathology*; D009061:Mouth Mucosa / Q000473:pathology; D009062:Mouth Neoplasms / Q000556:secondary*; D009362:Neoplasm Metastasis; D021362:Palate, Hard / Q000473:pathology; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D014456:Ulcer / Q000473:pathology*