title: Gingival metastasis as first sign of multiorgan dissemination of epithelioid malignant mesothelioma.
abstract: BACKGROUND
  Metastatic malignant mesothelioma to the oral cavity is extremely rare. They are more common in the jaw bones than the soft tissue. Occurrence of the malignant disease typically carries an average survival rate of 9-12 months
  
  
  METHODS
  : Thirteen patients underwent neoadjuvant chemotherapy and radical pleurectomy decortication, followed by radiotherapy from August 2012 to September 2013. Patients were followed up with computed tomography of the chest and the abdomen every 3 months. All patients were followed up until February 2014.
  
  
  RESULTS
  In January 2014, 11 patients were still alive with a median survival of 11 months, eight patients developed a recurrence and two patients died at 8 and 9 months after surgery. After 1 year from macroscopic radical pleurectomy decortication, a 68-year-old man suffered from gingival mass turned out to be a metastatic deposit of biphasic malignant mesothelioma as first sign of multiorgan recurrence. The patient underwent chemotherapy and local radiotherapy in the oral cavity.
  
  
  CONCLUSIONS
  This case points out the relevance of biopsy to all new growing lesions, even in uncommon anatomical sites, whenever a history of mesothelioma is on record.
authors.affiliation: *Departments of Thoracic Surgery; †Department of Medical Oncology; ‡Department of Pathology and Laboratory Medicine, PET Center Fondazione IRCCS Istituto Nazionale dei Tumori; §Department of Biomedical and Clinical Sciences "Luigi Sacco", Università degli Studi di Milano; and ‖Unit of Nuclear Medicine, PET Center Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Billè
authors.forename: Marco
authors.initials: M
authors.lastname: Platania
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pelosi
authors.forename: Barbara
authors.initials: B
authors.lastname: Padovano
authors.forename: Pasquale
authors.initials: P
authors.lastname: Quattrone
authors.forename: Ugo
authors.initials: U
authors.lastname: Pastorino
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D059248:Chemoradiotherapy; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D005887:Gingival Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D005971:Glutamates / Q000008:administration & dosage; D006147:Guanine / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000556:secondary* / Q000628:therapy*; D064847:Multimodal Imaging; D020360:Neoadjuvant Therapy; D000068437:Pemetrexed; D010994:Pleura / Q000601:surgery; D010997:Pleural Neoplasms / Q000473:pathology* / Q000628:therapy*; D049268:Positron-Emission Tomography; D018714:Radiotherapy, Adjuvant; D014057:Tomography, X-Ray Computed
chemical_list: D005971:Glutamates; D000068437:Pemetrexed; D006147:Guanine; D002945:Cisplatin