Metastatic bronchogenic carcinoma to the mandible

Abstract

A case of a metastasis of adenocarcinoma of the lung to a secondary site in the mandible, in a 53-year-old woman, is presented. The patient complained of trismus, swelling and numbness over the left side of face for 8-weeks. Examination revealed limited left condylar mobility, a firm tender swelling the angle of the mandible and paresthesia of the left inferior alveolar nerve. Computed Tomography revealed an osteolytic lesion in the left angle and ascending ramal region suggestive of a malignant tumor. Her chest radiograph findings were of a diffuse homogenous opacification with ipsilateral pleural effusion pointing to a pneumonic process. Histology features were of moderately differentiated adenocarcinoma. A search for the primary included a bronchial biopsy which revealed, the primary lesion was from the lung. This rare case highlights the difficulty and challenges in making the diagnosis clinicians may encounter in establishing the primary site of metastatic disease. There is need to develop high index of suspicion with regards to metastasis to the Craniofacial and mandibular bones. Multidisciplinary team approach is recommended when dealing with such patients.