Mandibular metastasis in a patient with undiscovered lung cancer: a case report

Abstract

Metastatic tumors account for 1% of all oral malignancies. Jawbone metastasis is uncommon. The mandible is the most frequent site. It is rare in the oral soft tissues, accounting for only 0.1% of oral malignancies. The majority of metastatic cases (70%) reported in the literature have primary tumors located in the lung, breast, kidney and colon. The clinical presentation of metastatic tumors is variable. This may create diagnostic dilemma and may lead to erroneous diagnoses. In this work, we present the radiological monitoring and the diagnostic dilemma of a mandibular metastasis resulting from a lung cancer. We report a case of a 57-year-old man who was referred to our department for the treatment of a left buccal cellulitis. On extra-oral examination, the patient presented a non-painful mass on the left mandibular ramus. The panoramic radiography showed a radiolucent lesion in the ramus with enlargement of the mandibular foramen. After excision of the jaw mass, histology revealed a metastatic adenocarcinoma having a lung origin. Mandibular metastasis may be the first presenting feature of an underlying occult malignancy of another primary site. Clinicians should always maintain a high index of suspicion for the possibility that a radiolucent lesion could be a metastatic tumor. Lip and chin hypoesthesia is an important symptom for malignancy detection.

Keywords

• oral metastasis ; lung cancer; prognosis.