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

Abstract

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.

Metastatic tumors to the jaws and oral cavity

“…[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. The role of trauma to the oral mucosa, especially from ill-fitting dentures, sharp tooth or restorations, poor oral hygiene and tooth extraction trauma, in the causation of oral metastasis needs further investigation.…”

The Treatment of Acute Periodontal Abscess and Secondary Occlusal Trauma: A Case Report

“…The dentist should keep a high level suspicion while evaluating patients with cancer history. A 55-year-old woman presented a rare metastatic carcinoma case, although the lesion resembled a periodontal abscess [6].…”

Metastatic cervical carcinoma of the jaw presenting as periapical disease

“…, Poulias et al . ). Breast and cervical cancers are generally considered to be the most important cancers amongst women (Luciani et al .…”

“…, Poulias et al . , Abdulrahman & Rahman ). Cervical cancer is the second most common cancer in women and is the second major primary site associated with oral metastases (Nishimura et al .…”