Atypical mandibular metastasis as the first presentation of a colorectal cancer

Abstract

We describe a case of a 70-year-old man presenting with a mandibular metastasis as the first sign of a mucinous adenocarcinoma of the rectum. After 6 months of a protracted toothache, the patient presented with a palpable mandibular mass and trismus, precluding adequate clinical evaluation. A CT scan was performed, and imaging findings suggested an aggressive primary jawbone tumour, most likely an osteosarcoma. However, biopsy and further patient's management proved to be a metastasis. Metastasis to the oral cavity account for only 1%-3% of all malignant oral tumours, and the mandible is the most frequent site. Clinical presentation can be quite variable, and most often a primary malignancy is already known. Jawbone metastases are a sign of disseminated malignant neoplasms, with poor prognosis and usually an indication for palliative therapy.

Two pathological fractures due to mandibular metastasis, rare in colon cancer; a case report presentation

“…Pain, swelling, limited mouth opening and paraesthesia are the most common symptoms of pathologic mandibular fractures 2 . However, these symptoms could be ignored by patients who suffer various symptoms of primary malignancies and treatment side effects.…”

“…Although lung cancer in men and breast cancer in women are the most common primary origin of metastases; kidney, liver, prostate and colorectal cancer metastases are also observed 3 . Toothache, swelling, and numbness are the most common symptoms 2 . In this report we aimed to describe the presentation of pathologic mandibular fractures due to metastasis of the colon cancer.…”

“…Pathological mandibular fractures are uncommon and represent less than 2% of all mandibular fractures 1 . Metastases to the oral region represent only 1%–3% of all malignant oral neoplasms and the mandible is the most common location 2 . Although lung cancer in men and breast cancer in women are the most common primary origin of metastases; kidney, liver, prostate and colorectal cancer metastases are also observed 3 .…”

“…Although lung cancer in men and breast cancer in women are the most common primary origin of metastases; kidney, liver, prostate and colorectal cancer metastases are also observed 3 . Toothache, swelling, and numbness are the most common symptoms 2 .…”

Perimandibular metastasis of rectal cancer: A case report

“…However, in 4 patients, the oral/maxillofacial lesion was the only metastatic site. Metastases to the oral and maxillofacial region could sometimes be the first sign of colorectal cancer (11). Treatment of oral and maxillofacial metastatic disease was multidisciplinary, consisting of chemotherapy, radiotherapy and surgery as well (5 cases) (4), unfortunately without long-term success.…”