Metastatic Hepatocellular Carcinoma on the Mandibular Gingival-Case Report

Hepatocellular carcinoma (HCC) is a common tumor in Taiwan. HCC usually causes transvascular metastasis to the lungs, peritoneum, bone, intracelial organs, and adrenal glands, but rarely to the oral tissues. This article reports a case of HCC in a 62-year-old male patient with metastasis to the left posterior mandibular gingiva. The metastatic HCC was totally excised. No evidence of invasion of the mandibular bone was found. Histopathologically, the tumor cells were positive for hepatocyte-specific antigen (HSA) and low-molecular-weight cytokeratin and focally positive for high- molecular-weight cytokeratin, but were negative for α-fetoprotein. The anti-CD31 and anti-CD34 immunostaining highlighted the intervening sinusoidal spaces between the tumor cell nests and trabeculae, and strongly supported the diagnosis of HCC. The patient died of progressive HCC 2.5 months after excision of the oral metastatic tumor, and no recurrence of oral lesion was found. We suggest that the diagnosis of a metastatic HCC requires immunohistochemical studies with a panel of liver-specific antibodies. Hepatocyte-specific antigen is a highly specific marker of HCC. Although tumor cells of HCC are negative for CD 31 and CD34, anti-CD31 and anti-CD34 immunostaining can highlight the growth pattern of HCC and provide support for the diagnosis of HCC.

並列關鍵字

hepatocellular carcinoma ； gingival metastasis ； hepatocyte-specific antigen ； CD31 ； CD34

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