Treatment strategy for maxillary gingival metastasis arising from gastric adenocarcinoma: A case report and literature review

Gastric cancer metastasizing to the gingiva is rare. The present study reports a case of maxillary gingival metastasis arising from gastric cancer treated with chemotherapy, surgical excision and radiotherapy. A 55-year-old male, who received chemotherapy with trifluridine/tipiracil for treatment of refractory gastric cancer with multiple metastasis, was admitted to the Department of Dentistry and Oral Surgery, Tohoku Medical and Pharmaceutical University Hospital (Sendai, Japan) in December 2023 because of the right side of the maxillary gingival mass presenting with protruding growth. The size of the tumor was ~20 mm. Tumor excision was performed followed by histopathological diagnosis which revealed a metastatic gingival tumor originating from gastric adenocarcinoma. Consequently, the patient underwent a palliative Radiation Therapy Oncology Group 8502 'QUAD shot' regimen. Although there was no progression of oral lesion, the patient died 3 months after diagnosis of gingival metastasis. The present study reviewed previous case records of gingival metastasis originating from gastric cancer and summarized treatment modalities along with clinicopathological association. In conclusion, the prognosis of patients with metastases to the oral region (MOR) is usually unfavorable. For the management of MOR, a multidisciplinary team approach is necessary to develop appropriate treatment strategies. If there are possibilities to improve prognosis or quality of life, the consideration of combination therapy with radical or palliative intent is warranted.