Mandible metastasis as the initial manifestation of breast carcinoma--report of a case.

A case is presented in which the only positive subjective and clinical findings were numbness of the lower lip and chin, generalized tooth mobility with dull pain, and swelling of the right lower jaw. After an appropriate and careful workup, in conjunction with other medical colleagues, a definitive diagnosis of adenocarcinoma of breast metastasis to the mandible was made, which was confirmed by a histopathologic examination. Radiographs disclosed radiolucent change with an irregular and a moth-eaten appearance in the mandibular trabeculation and loss of the lamina dura of several teeth. As this case demonstrates, the diagnosis of metastatic disease of the jaws requires a high degree of diagnostic astuteness, because of the many possible clinical signs and symptoms which can be nonspecific and can resemble diseases of an inflammatory origin. Accordingly, a histologic evaluation is essential in establishing a definitive diagnosis. The case report emphasizes the need for consideration of metastatic disease in the differential diagnosis of unknown oral lesions, especially in the mandible.