Rare Gingival Metastasis Occurring After Conversion Therapy Followed by Resection of Initially Unresectable Hepatocellular Carcinoma: A Case Report

Juncheng Zhan,1,2,* Hongwei Huang,1,* Tianao Zhan,1 Xinkang Liu,1 Qi Cheng1 1Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, People’s Republic of China; 2Department of Clinical Medicine, Be...

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Main Authors: Zhan J, Huang H, Zhan T, Liu X, Cheng Q
Format: Article
Language:English
Published: Dove Medical Press 2025-04-01
Series:Journal of Hepatocellular Carcinoma
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Online Access:https://www.dovepress.com/rare-gingival-metastasis-occurring-after-conversion-therapy-followed-b-peer-reviewed-fulltext-article-JHC
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author Zhan J
Huang H
Zhan T
Liu X
Cheng Q
author_facet Zhan J
Huang H
Zhan T
Liu X
Cheng Q
author_sort Zhan J
collection DOAJ
description Juncheng Zhan,1,2,* Hongwei Huang,1,* Tianao Zhan,1 Xinkang Liu,1 Qi Cheng1 1Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, People’s Republic of China; 2Department of Clinical Medicine, Bengbu Medical University, Bengbu, Anhui Province, 233004, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qi Cheng, Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jie Fang Avenue, Qiaokou, Wuhan, Hubei Province, 430030, People’s Republic of China, Email chengqi@hust.edu.cnAbstract: Gingival metastases from hepatocellular carcinoma (HCC) are exceedingly rare and highly prone to be misdiagnosed without biopsy. Here, we report an initially unresectable HCC patient who received effective conversion therapy but discovered gingival metastasis within one-month post-hepatectomy. A 53-year-old male with a huge liver tumor diagnosed as unresectable HCC received conversion therapy of hepatic arterial infusion chemotherapy (HAIC) combined with lenvatinib and tislelizumab. During the conversion therapy, he experienced sore gingiva which was regarded as a side effect of lenvatinib. Considering the significant shrinkage of tumor after 10-month treatment, salvage resection was conducted with negative margin and no postoperative complications. Gingival oligometastases were identified and resected half month after surgery. Throughout the 1-year follow-up period, the patient remained alive; however, there was a recurrence of the gingival metastasis at the same site six months postoperatively. Hence, clinicians should regard gingival swelling and pain not merely as potential adverse events of conversion therapy but also as potential indicators of gingival metastasis.Keywords: hepatocellular carcinoma, conversion therapy, gingival metastasis, adverse event, immune checkpoint inhibitors, anti-angiogenic drugs, case report
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issn 2253-5969
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publishDate 2025-04-01
publisher Dove Medical Press
record_format Article
series Journal of Hepatocellular Carcinoma
spelling doaj-art-59865d8499cf4cd99dde5e5750097ada2025-08-20T03:09:11ZengDove Medical PressJournal of Hepatocellular Carcinoma2253-59692025-04-01Volume 12705713101947Rare Gingival Metastasis Occurring After Conversion Therapy Followed by Resection of Initially Unresectable Hepatocellular Carcinoma: A Case ReportZhan JHuang HZhan TLiu XCheng QJuncheng Zhan,1,2,* Hongwei Huang,1,* Tianao Zhan,1 Xinkang Liu,1 Qi Cheng1 1Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, People’s Republic of China; 2Department of Clinical Medicine, Bengbu Medical University, Bengbu, Anhui Province, 233004, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qi Cheng, Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jie Fang Avenue, Qiaokou, Wuhan, Hubei Province, 430030, People’s Republic of China, Email chengqi@hust.edu.cnAbstract: Gingival metastases from hepatocellular carcinoma (HCC) are exceedingly rare and highly prone to be misdiagnosed without biopsy. Here, we report an initially unresectable HCC patient who received effective conversion therapy but discovered gingival metastasis within one-month post-hepatectomy. A 53-year-old male with a huge liver tumor diagnosed as unresectable HCC received conversion therapy of hepatic arterial infusion chemotherapy (HAIC) combined with lenvatinib and tislelizumab. During the conversion therapy, he experienced sore gingiva which was regarded as a side effect of lenvatinib. Considering the significant shrinkage of tumor after 10-month treatment, salvage resection was conducted with negative margin and no postoperative complications. Gingival oligometastases were identified and resected half month after surgery. Throughout the 1-year follow-up period, the patient remained alive; however, there was a recurrence of the gingival metastasis at the same site six months postoperatively. Hence, clinicians should regard gingival swelling and pain not merely as potential adverse events of conversion therapy but also as potential indicators of gingival metastasis.Keywords: hepatocellular carcinoma, conversion therapy, gingival metastasis, adverse event, immune checkpoint inhibitors, anti-angiogenic drugs, case reporthttps://www.dovepress.com/rare-gingival-metastasis-occurring-after-conversion-therapy-followed-b-peer-reviewed-fulltext-article-JHChepatocellular carcinomaconversion therapygingival metastasisadverse eventimmune checkpoint inhibitorsanti-angiogenic drugscase report
spellingShingle Zhan J
Huang H
Zhan T
Liu X
Cheng Q
Rare Gingival Metastasis Occurring After Conversion Therapy Followed by Resection of Initially Unresectable Hepatocellular Carcinoma: A Case Report
Journal of Hepatocellular Carcinoma
hepatocellular carcinoma
conversion therapy
gingival metastasis
adverse event
immune checkpoint inhibitors
anti-angiogenic drugs
case report
title Rare Gingival Metastasis Occurring After Conversion Therapy Followed by Resection of Initially Unresectable Hepatocellular Carcinoma: A Case Report
title_full Rare Gingival Metastasis Occurring After Conversion Therapy Followed by Resection of Initially Unresectable Hepatocellular Carcinoma: A Case Report
title_fullStr Rare Gingival Metastasis Occurring After Conversion Therapy Followed by Resection of Initially Unresectable Hepatocellular Carcinoma: A Case Report
title_full_unstemmed Rare Gingival Metastasis Occurring After Conversion Therapy Followed by Resection of Initially Unresectable Hepatocellular Carcinoma: A Case Report
title_short Rare Gingival Metastasis Occurring After Conversion Therapy Followed by Resection of Initially Unresectable Hepatocellular Carcinoma: A Case Report
title_sort rare gingival metastasis occurring after conversion therapy followed by resection of initially unresectable hepatocellular carcinoma a case report
topic hepatocellular carcinoma
conversion therapy
gingival metastasis
adverse event
immune checkpoint inhibitors
anti-angiogenic drugs
case report
url https://www.dovepress.com/rare-gingival-metastasis-occurring-after-conversion-therapy-followed-b-peer-reviewed-fulltext-article-JHC
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