Case report reveals rare gingival metastasis from a thoracic SMARCA4-deficient undifferentiated tumor in an older smoker, highlighting the diagnostic role of dental clinicians.
Introduction: Thoracic SMARCA4-deficient Undifferentiated Tumors (SMARCA4-UT) are rare and aggressive malignancies. This case is unique as it describes the first gingival metastasis from thoracic SMARCA4-UT, emphasizing the diagnostic role of dental professionals. Observation : A 71-year-old man, heavy smoker (50 pack-years), presented with chest pain, dyspnea, weight loss, and a gingival lesion. Oral examination revealed poor oral health with severe periodontitis, trismus, halitosis, pain on palpation, and a 3 cm friable gingival tumor in sector 2. Premolars showed grade 3 mobility and loss of vitality. 3D imaging confirmed tumor extension. CT, PET-CT, revealed thoracic, adrenal masses and multiple metastases. Histopathology confirmed SMARCA4-UT with gingival metastasis. Outcome : The patient's condition deteriorated rapidly, and he died before treatment could be initiated. Conclusion : Dental professionals play a key role in suspecting systemic disease from oral manifestations. This case underscores the importance of considering metastasis in atypical oral tumors.
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Lagrost et al. (2025) studied this question.
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