Breast Cancer Metastatic to the Mandible Misdiagnosed as Parotitis: Report of a Case

Oral metastasis intraosseous mimicking periapical lesion: a case report

ABSTRACT Jaw metastasis can be mistaken for inflammatory or infectious diseases. Then, they should be considered in the differential diagnosis of unknown jaw lesions. Study reported here involved metastasis of breast cancer in the mandible of a 45-year-old woman. The most important differential diagnostic was a reactive lesion in an unusual periapical location associated with a nonvital tooth. However, given patient’s medical history and because paresthesia and pain were observed a few days after pulpectomy, metastasis of breast cancer could not be ruled out. When bone scintigraphy suggested the metastasis of a malignant bone tumor, incisional biopsy was performed. Histopathologic examination and immunohistochemical reaction confirmed the diagnosis of metastasis of breastcancer, and chemotherapy was thus performed as well. Unfortunately, patient died 2 years after diagnosis. Dentists as well as general physicians should therefore consider presence of oral metastasis in cases involving atypical symptoms, especially in patients with known malignant disease.

Validating of the pre-clinical mouse model for metastatic breast cancer to the mandible

Metastatic breast carcinoma has a great tendency to spread to the mandible. It is concomitantly associated with bone destruction, food intake disorder, and a poorer prognosis. Appropriate animal models need to be developed for a better understanding of the mechanisms underlying the metastatic process of breast cancer cells to mandible and to test the effects of potential lead compounds. Here, we assessed the metastasis model of intracardiac injection using luciferase-transfected metastatic breast cancer cells (MDA-MB-231^Luc+) by determining the incidences of metastasis, mCT images, and histopathological results. A high bioluminescence signal mainly detected mandibular lesions with less frequent distal femora and proximal tibiae lesions. Extensive mandibular bone destruction occurred in nude mice grafted with metastatic breast cancer cells. This type of animal model might be a useful tool in assessing therapeutic implications and the efficacy of anti-cancer drugs for osteolytic cancers.

A rare case of breast carcinoma metastasis to mandible and vertebrae

Oral cavity metastases are considered rare and represent approximately 1% of all oral malignancies. Due to their rarity and atypical clinical and radiographic appearance, metastatic lesions are considered a diagnostic challenge. This article presents a rare case of breast carcinoma with metastasis to mandible and vertebrae. A case is presented of a 40-year-old female patient with a history of breast carcinoma which was surgically treated approximately 2 years back. The diagnosis of metastatic breast carcinoma was confirmed by radiographic examination, bone scan and histopathologic findings. She was referred to radiotherapy department since it was not amenable to surgery due to metastasis in vertebrae. A high index of clinical suspicion of metastatic cancer is necessary when evaluating patients who complaint of jaw pain and swelling with a history of non-head and neck carcinoma.

Buccal metastasis in a case of carcinoma breast: A rare case report with review of literature

INTRODUCTION

Metastatic lesions to oral cavity from distant tumours account for 1% of all oral cavity malignancies. Oral cavity is a rare site of metastasis from the breast. We describe case report of breast cancer patient with metastasis to buccal mucosa.

PRESENTATION OF CASE

We report a case of pre-menopausal woman with left side infiltrating ductal carcinoma breast - T4aN1M0. She received three cycles of neo-adjuvant chemotherapy followed by modified radical mastectomy (MRM) and three cycles of adjuvant chemotherapy and loco-regional EBRT. She presented with a lump in region of MRM scar and a painful swelling in the right cheek, one year afterwards. Core needle biopsy from scar site revealed infiltrating ductal carcinoma. CECT revealed a heterogeneous lesion (1.1cm×1.7cm) in right masticator space, which on biopsy revealed metastatic deposit consistent with infiltrating ductal carcinoma.

DISCUSSION

Metastatic lesions to oral cavity from distant tumours are uncommon. They mainly involve bony structures. Primary metastases to soft tissues are rare and accounts for 0.1% of oral malignancies. In our case, patient presented with scar recurrence and distant metastasis at an unusual site. Had it not been for scar recurrence, patient might not have presented to the OPD with oral swelling. A high degree of clinical suspicion and previous history of breast cancer led to detection of metastatic deposit.

CONCLUSION

Diagnosis of a metastatic lesion in buccal mucosa is challenging and requires a high degree of clinical suspicion.

Metastatic breast carcinoma initially diagnosed as pulpal/periapical disease: a case report

INTRODUCTION

Metastatic tumors to oral cavity and jaws are rare, and mandible is the most commonly involved location. Because the most common jaw symptom is pain, these lesions could be misdiagnosed as pathologic entities with dental origin. In this article a case of metastatic breast carcinoma initially diagnosed as pulpal/periapical disease is presented and discussed.

METHODS

A 40-year-old female patient was referred to our department with vague pain in right mandibular area. Clinical and radiographic examinations were performed, leading to the initial diagnosis. Patient's medical history was reevaluated, and an incisional biopsy was performed to confirm the final diagnosis.

RESULTS

Regarding the initial signs and symptoms, a pulpal/periapical inflammatory process was considered in the differential diagnosis. Because lip paresthesia was also noted, a more aggressive process was suspected. Patient's medical records and histopathologic slides were requested and reviewed carefully. The diagnosis of metastatic breast carcinoma was confirmed by comparing the histopathologic findings of the jaw lesion with previous slides of the breast.

CONCLUSIONS

Despite their rarity, metastatic tumors should be considered in the differential diagnosis of inflammatory and reactive lesions of the jaws. These lesions might be diagnosed first by the patient's dentist or by the maxillofacial surgeon. This case emphasized the importance of a complete and careful work-up with particular attention to detailed medical history as well as careful clinical and radiographic inspection for unusual signs and symptoms.