Presentation of cervical metastases and pathological mandibular fracture due to pulmonal adenocarcinoma: A case report

Abstract

Introduction: Oral metastatic tumors due to malignancies at distant locations are very rare. There are only few cases in the literature reporting about mandible/cervical metastases. Sometimes the oral finding is the manifestation of the disease.

Presentation of case: We report on a 50-year-old patient who was diagnosed with a pathological mandibular fracture and cervical lymph node metastases due to an adenocarcinoma of the lung without other peripheral metastases. Following the interdisciplinary tumor board decision, resection and ipsilateral neck dissection including a mandible reconstruction using a microvascular fibula transplant was performed. The patient received an adjuvant chemotherapy with carboplatin/pemetrexed.

Discussion: The combination of cervical metastases and a pathological mandibular fracture has not been reported before. Distinction between oligometastatic and polymetastatic disease may be difficult. Bone lesions and a high number of metastases are associated with a negative outcome. In cases of limited oligometastatic diseases, metastasectomy might sometimes be indicated. Due to the absence of other peripheral metastases decision of metastasectomy was made.

Conclusion: Due to rare occurrence of cervical metastases special attention should be paid to the incidence of possible metastases of distant malignancies at uncommon regions.

Keywords: Case report; Cervical metastasis; Fibula transplant; Mandible reconstruction; Pathological mandibular fracture.