Gingival Tumor as the First Sign of Advanced Hepatocellular Carcinoma on FDG PET/CT

Metastatic tumors of the oral cavity are rare. They account for approximately 1% of all malignant oral tumors. The most common site of oral metastasis is the mandible rather than the oral soft tissues. Gingival metastasis of hepatocellular carcinoma (HCC) is even rarer. The lung is the most common site of ab extrahepatic metastasis. We report a 60-yearold man who presented with a gingival tumor and had an F-18 FDG PET/CT scan for disease evaluation. The scan revealed hypermetabolic hepatic tumors. Subsequently, HCC with a gingival metastasis was proved by biopsy with an immunohistochemical analysis of the 2 sites.