Prostate adenocarcinoma mandibular metastasis associated with numb chin syndrome: a case report

Abstract

The purpose of this study is to report a rare case of mandibular adenocarcinoma that was diagnosed due to metastasis from the prostate. Numb chin syndrome (NCS), which was associated with this case, is also discussed. Computed tomography (CT) and an intraoral incisional biopsy of the left mandibular area were performed. Urology consultation, hormone therapy, chemotherapy and follow-up radiographic images were administered. Histological examination of the incised specimen revealed moderately differentiated adenocarcinoma. The Gleason score was 8 (primary 4/secondary 4). Immunohistochemical features and radiographic results confirmed the diagnosis of metastasis from prostate adenocarcinoma, moderately differentiated. The patient's prostate-specific antigen (PSA) level was very high. After hormone treatment, the patient's PSA levels dropped gradually. Seventeen months later, in May 2015, the PSA level was elevated. The 18-month follow-up CT image indicated that the patient's condition was aggravated. Docetaxel chemotherapy was started in June 2015 (18 months later), and the sixth cycle of the therapy is in progress. Oral metastases that originate from prostate adenocarcinoma are rare and can induce various periosteal reactions. Hormone therapy, chemotherapy and close follow-up could be additional, appropriate treatment, and were applied in this case. Finally, NCS is a valuable indicator of metastatic disease in the mandible.

Jaw Metastasis from a Prostate Adenocarcinoma Associated with Numb Chin Syndrome: Case Report

“…Prostate carcinoma (PCa) is the most common form of cancer that affects men and adenocarcinoma corresponds to 95% of malignancies [1] Approximately 7.5% of prostate cancer shows no symptoms, meaning men do not seek medical support [2,3], resulting in an advanced-stage of disease, with multiple metastases [4]. Approximately 1% of oral cancers are metastases and can be found on soft tissue or jaw bones [5,6].…”

“…One of the signs of oral metastasis can be numb chin syndrome (NCS) due to the involvement of the inferior alveolar of the mandible nerve. [4,5,7,8] NCS describes a sensory neuropathy characterized by numbness (hypoesthesia, paresthesia, dysesthesia, anesthesia) in the distribution of the terminal branch of the mandibular division of the trigeminal nerve and may be caused by nerve damage occurring during dental and maxillofacial therapies, including mandibular block [9] (Fig. 1).…”

“…The systematic review had used the term mental nerve neuropathy (MNN) which is a neurological manifestation of cancer, characterized by numbness in the region innervated by the mental nerve: skin of the chin, oral mucosa, and lower lip of the affected hemisphere, too [1]. Since PCa can be silent, it is important for healthcare professionals to be aware that paresthesia or any level of This article is part of the Topical Collection on Medicine pain or sensory discomfort around the chin, lower lip, or gingiva mucosa could be indicative of a malignant process occurring in the patient's body [4,7].…”

Metastasis of a prostate adenocarcinoma to mandible: A case report and review of literature

“…Most frequently, patients were in their 7th and 8th decades of life. 2,[7][8][9] The most common chief complaints of the patients were pain and swelling, and other manifestations such as paresthesia, limited mouth opening, and preauricular pain were also reported. 3,8,10 Radiographic feature showing periosteal reactions can be classified as single layer, multilayered, solid, speculated, perpendicular, sloping, complex, Codman triangle, and sunburst.…”

“…Metastases cases of mandible reported in the literature were mostly in angle and body region and rarely in condylar area. Most frequently, patients were in their 7th and 8th decades of life 2,7–9 . The most common chief complaints of the patients were pain and swelling, and other manifestations such as paresthesia, limited mouth opening, and preauricular pain were also reported 3,8,10 …”