Diagnóstico diferencial de metástase em lesões que simulam periodontite apical: uma revisão integrativa da literatura

Abstract

Metastasis is understood as a secondary growth of the tumor cells of a primary tumor, which dissipate to other distant organs and tissues through the lymphatic or circulatory blood system. Metastatic tumors in the oral cavity are rare cases that are most often located in the area of the lower molars, but can appear in the maxilla, in the soft tissues of the mouth or involve both soft and hard tissues at the same time. The objective of this work was to analyze the differential diagnosis of metastases in lesions that simulate apical periodontitis. This research is a review of integrative literature, performed through a search in the Medline database (via Pubmed), using the following descriptors: "metastic OR metastases AND periapical OR periodontitis". Metastases in the oral cavity are a late complication of a secondary neoplasm originating from another organ or tissue, and may be associated with multiple metastatic lesions. The most important clinical signs and symptoms are pain, tenderness, dysphagia, difficulty during chewing, disfigurement, ulcers and intermittent bleeding, which causes a low quality of life. Metastatic lesions are extremely rare cases, so they can be easily confused, leading to erroneous and late diagnosis. Thus, it is necessary to perform a differential diagnosis through pulp vitality tests, clinical and radiographic findings.