Palatine mucosal metastatic lesion of pulmonary origin. A case report and bibliographical survey. Lesión metastásica de origen pulmonar en la mucosa palatina. Presentación de caso y revisión de la literatura.
Description
This is a case of metastasis in a 42-year-old male patient who presented to the Department of Oral Medicine, School of Dentistry, UNPHU, because of a purple discoloration on his palate. His medical history was completed and when questioned, he mentioned that he had undergone surgery for a lung lesion 10 years ago, of which he could not provide details, and regarding the lesion he presented, he stated that it had been developing for a few months and that it was not painful. On intraoral clinical examination, he presented a violaceous plaque, oval in shape, approximately 4 mm, with defined margins, slightly indurated on palpation, located on the mucosa of the hard palate on the right side. Based on the characteristics of the lesion and taking into account the patient's history, a presumptive diagnosis of Kaposi's sarcoma vs. lymphoma was suggested. The patient was referred for a hemogram and preoperative tests to obtain an incisional biopsy, the results of which ruled out HIV, and once the biopsy was obtained, it was sent for histopathologic examination. At the post-operative evaluation seven days later, the patient showed a favorable healing pattern. Pre-diagnosed was moderately differentiated infiltrating adenocarcinoma. When the patient received the results of the lung biopsy performed years ago, it was found that it was the same diagnosis, for this reason the patient was referred to an oncology hospital where a PET-CT study was indicated, which showed new pulmonary lesions. Currently, the patient is undergoing chemotherapy and awaiting surgical planning for the metastatic lesion in the palate.
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Steps to reproduce
As a method for collecting information on the case, we first filled in the clinical history of the patient, who provided us with relevant data on the lesion. After this, an intraoral mirror was used to continue with the oral examination in which the clinical characteristics of the lesion were analyzed. For the insitional biopsy, a basic kit was used, mirror, cotton tweezer and explorer, scalpel number 15c, lidocaine 2% and a surgical dressing to protect the area during recovery. A diamond-shaped incision was made around the lesion, integrating also healthy edges. The sample was extracted and taken to the laboratory for study.