Atypical mandibular metastasis as the first presentation of a colorectal cancer

BMJ Case Rep. 2018 Jun 4:2018:bcr2018225094. doi: 10.1136/bcr-2018-225094.

Abstract

We describe a case of a 70-year-old man presenting with a mandibular metastasis as the first sign of a mucinous adenocarcinoma of the rectum. After 6 months of a protracted toothache, the patient presented with a palpable mandibular mass and trismus, precluding adequate clinical evaluation. A CT scan was performed, and imaging findings suggested an aggressive primary jawbone tumour, most likely an osteosarcoma. However, biopsy and further patient's management proved to be a metastasis. Metastasis to the oral cavity account for only 1%-3% of all malignant oral tumours, and the mandible is the most frequent site. Clinical presentation can be quite variable, and most often a primary malignancy is already known. Jawbone metastases are a sign of disseminated malignant neoplasms, with poor prognosis and usually an indication for palliative therapy.

Keywords: colon cancer; head and neck cancer; oncology; radiology.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma, Mucinous / diagnostic imaging
  • Adenocarcinoma, Mucinous / pathology
  • Adenocarcinoma, Mucinous / secondary*
  • Aged
  • Biopsy
  • Colorectal Neoplasms / diagnostic imaging
  • Colorectal Neoplasms / pathology
  • Humans
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / secondary
  • Male
  • Mandibular Neoplasms / diagnostic imaging
  • Mandibular Neoplasms / pathology
  • Mandibular Neoplasms / secondary*
  • Rectal Neoplasms / diagnostic imaging
  • Rectal Neoplasms / pathology*
  • Tomography, X-Ray Computed