Metastatic Breast Carcinoma Initially Diagnosed as Pulpal/Periapical Disease: A Case Report

Khalili, Mohammad; Mahboobi, Nima; Shams, Jalaleddin

doi:10.1016/j.joen.2010.01.010

Cited by 15 publications

(15 citation statements)

References 14 publications

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“…[48] Recently, a case of a metastatic breast carcinoma mimicking as periodontal abscess in the mandible has been reported. [49] In few cases tooth extraction preceded the discovery of the metastasis.…”

Section: Discussionmentioning

confidence: 99%

Metastatic tumors to the jaws and oral cavity

Kumar

Manjunatha

2013

J Oral Maxillofac Pathol

124

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Cancer is a disease involving complex multiple sequential irreversible dysregulated processes showing metastasis that results in morbidity and mortality. Metastasis is a complex biological course that begins with detachment of tumor cells from the primary tumor, spreading into the distant tissues and/or organs, invading through the lymphovascular structures followed by their survival in the circulation. Metastatic tumors to the oro-facial region are uncommon and may occur in the oral soft tissues or jawbones. The clinical presentation of metastatic tumors can be variable, which may lead to erroneous diagnosis or may create diagnostic dilemma. Therefore, they should be considered in the differential diagnosis of inflammatory and reactive lesions that are common to the oral region. Most of the literature on oral metastases involves either single case reports or reviews of these reported cases from scattered geographical areas. Hence this present article is an attempt to provide a detailed review of pathogenesis, epidemiological details including clinical and radiographic presentations, microscopic features and treatment of metastatic tumors to the jaws and oral cavity.

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Section: Discussionmentioning

confidence: 99%

Metastatic tumors to the jaws and oral cavity

Kumar

Manjunatha

2013

J Oral Maxillofac Pathol

124

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“…On the basis of this principle, endodontists should take into account clinical aspects, radiographic findings, and the patient's dental history [20] and attempt to ascertain whether absence of response to thermal pulp testing is a transient phenomenon or attributable to another etiology, such as transient paresthesia secondary to nerve compression [21]. …”

Section: Discussionmentioning

confidence: 99%

“…At 30-day clinical follow-up, these teeth were found to be responsive to thermal pulp testing, thus demonstrating their viability and that the initial response was unreliable [21]. …”

Section: Discussionmentioning

confidence: 99%

Decompression of a Large Periapical Lesion: A Case Report of 4-Year Follow-Up

Maníglia-Ferreira

Gomes

Vitoriano

et al. 2016

Case Reports in Medicine

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This case report described the endodontic treatment and decompression of an extensive lesion in the anterior region of the mandible, detected during clinical and radiographic examination, in a patient with a complaint of slight tenderness to palpation in the area of mandibular right lateral incisor and canine. These teeth had been accessed without proper clinical evaluation, and their pulp tissues were exposed. The periodontal tissues were healthy, with no signs of inflammation or fistula. On radiographic examination, a radiolucent lesion with well-defined borders was seen extending from the distal root of mandibular left second premolar to the mesial root of mandibular right second premolar. Central and lateral mandibular left incisors were unresponsive to thermal pulp testing and exhibited coronal discoloration, consistent with a diagnosis of pulp necrosis. Due to persistent discharge from the root canal system during endodontic procedures despite application of intracanal medicament (calcium hydroxide paste), the decision was made to biopsy and decompress the lesion and conclude endodontic treatment. Histopathologic examination revealed a periapical granuloma. After endodontic treatment of the involved teeth, at 4-year clinical and radiographic follow-up, the affected region was almost completely repaired.

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“…Pain relief and avoidance of possible infections, fractures or hemorrhage should be the major goals [17]. Local radiotherapy is almost always the treatment of choice as it relieves pain, prevents loss of function and arrests growth of the tumor [18,19]. A combination of surgical excision and radiation therapy is used in most cases of soft-tissue metastases [19].…”

Section: Discussionmentioning

confidence: 99%

Metastatic breast carcinoma in the mandible presenting as a periodontal abscess: a case report

Poulias

Melakopoulos²,

Tosios

2011

J Med Case Reports

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IntroductionTumors can metastasize to the oral cavity and affect the jaws, soft tissue and salivary glands. Oral cavity metastases are considered rare and represent approximately 1% of all oral malignancies. Because of their rarity and atypical clinical and radiographic appearance, metastatic lesions are considered a diagnostic challenge. The purpose of this report is to present a rare case of a metastatic breast carcinoma mimicking a periodontal abscess in the mandible.Case presentationA 55-year-old Caucasian woman was referred to our clinic for evaluation of bisphosphonate-induced jaw osteonecrosis. She had undergone modified radical mastectomy with axillary lymph node dissection for invasive ductal carcinoma of the left breast. Her clinical examination showed diffuse swelling and a periodontal pocket of 6 mm exhibiting suppuration in the posterior right mandible. Moreover, paresthesia of the lower right lip and chin was noted. There were no significant radiographic findings other than alveolar bone loss due to her periodontal disease. Although the lesion resembled a periodontal abscess, metastatic carcinoma of the breast was suspected on the basis of the patient's medical history. The area was biopsied, and histological analysis confirmed the final diagnosis of metastatic breast carcinoma.ConclusionThe general dentist or dental specialist should maintain a high level of suspicion while evaluating patients with a history of cancer. Paresthesias of the lower lip and the chin should be considered ominous signs of metastatic disease. This case highlights the importance of the value of a detailed medical history and thorough clinical examination for the early detection of metastatic tumors in the oral cavity.

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Metastatic Breast Carcinoma Initially Diagnosed as Pulpal/Periapical Disease: A Case Report

Cited by 15 publications

References 14 publications

Metastatic tumors to the jaws and oral cavity

Metastatic tumors to the jaws and oral cavity

Decompression of a Large Periapical Lesion: A Case Report of 4-Year Follow-Up

Metastatic breast carcinoma in the mandible presenting as a periodontal abscess: a case report

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