Clinical–Pathological Conference: Case 6

Abstract

A 47-year-old male presented with a 5 cm, firm, painful swelling over the left mandibular ramus that had progressively enlarged and was associated with limitation of mandibular opening and trismus. He related that he first noted symptoms from the area shortly after dental treatment involving a tooth in his left lower jaw 2 months previously. He indicated a 72 pack-year history of cigarette smoking and currently smoked two packs of cigarettes per day. He reported minimal alcohol consumption.Since the swelling was initially believed to represent a lesion of the soft tissues, a fine needle aspiration biopsy was performed. When this did not yield diagnostic information, a computed tomographic (CT) scan was obtained. At the time of the scan, paresthesia of the left lower lip was observed.The CT scan revealed an expansile, aggressive-appearing process with a sunburst-type periosteal reaction surrounding the angle and ramus of the left mandible with extension into the infratemporal fossa just below the mandibular condyle (Figs.

Metastatic adenocarcinoma of mandible: in search of the primary

“…The presence of systemic symptoms like cough may give a clue in the diagnosis of the primary lesion 7. Radiographically, ill-defined radiolucency or moth-eaten appearance was seen in cases of metastatic lung carcinomas while metastases from prostate and breast can show mixed radiolucent radio-opaque appearance 11. A biopsy followed by whole-body examination was undertaken in all the cases for diagnosis.…”