title: Metastatic tumors to the gingiva and the presence of teeth as a contributing factor: a literature analysis.
abstract: BACKGROUND
  Gingiva that is prone to inflammation may serve as a pre-metastatic niche for the attraction of circulating malignant cells. The aim of this study is to analyze cases of metastatic lesions to the gingiva compared with cases metastasizing to other oral mucosal sites. The pathogenesis of gingival metastases is discussed, with emphasis on the role of inflammation.
  
  
  METHODS
  The English-language literature between 1916 and 2011 was searched for cases of metastatic lesions to the oral mucosa; only cases metastasizing in the oral mucosa, gingiva, and periodontium were included.
  
  
  RESULTS
  Two hundred seven cases were included. The gingiva was the most common site (60.4%), followed by tongue and tonsil. The most common primary sites were lung (24.2%), kidney (13.5%), skin (10.6%), and breast (8.7%). In 27%, the oral lesion was the first sign of a malignant disease. In most cases, the lesion appeared as an exophytic mass (96%) diagnosed clinically as a reactive gingival lesion. The presence of teeth was significantly associated with the development of gingival metastases: in 108 of 125 gingival metastases, the lesion was found adjacent to teeth (P <0.001; odds ratio = 8.2). The average life expectancy after diagnosis of the metastasis was 3.7 months.
  
  
  CONCLUSIONS
  The gingiva is the most common site for metastases to oral soft tissues, with strong association with the presence of teeth. This finding may be related to the role of inflammation in the attraction of metastatic cells to chronically inflamed gingiva.
authors: Department of Oral Pathology and Oral Medicine, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: Irit
authors: I
authors: Allon
authors: Aya
authors: A
authors: Pessing
authors: Ilana
authors: I
authors: Kaplan
authors: Dror M
authors: DM
authors: Allon
authors: Abraham
authors: A
authors: Hirshberg
mesh_terms: D003817:Dentition; D005887:Gingival Neoplasms / Q000556:secondary*; D005891:Gingivitis / Q000150:complications; D006801:Humans; D009061:Mouth Mucosa / Q000473:pathology; D009062:Mouth Neoplasms / Q000556:secondary