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Case Reports
. 2023 Dec;22(4):1176-1179.
doi: 10.1007/s12663-023-01964-x. Epub 2023 Jun 27.

Breast Ductal Infiltrative Adenocarcinoma Metastasis to the Mandible

Paolo Boffano  1   2 , Anna Maria Agnone  1 , Ilenia Zanellato  3 , Matteo Brucoli  4 , Vincenzo Rocchetti  1   4
Affiliations
Case Reports

Breast Ductal Infiltrative Adenocarcinoma Metastasis to the Mandible

Paolo Boffano et al. J Maxillofac Oral Surg. 2023 Dec.

Abstract

Metastatic lesions to the jaws are rare. The oral sites to which metastasis most commonly occur are the jaws, the gingiva, and the tongue. Lower jaw is a more frequent site of metastasis compared to the upper jaw with posterior areas (ramus, body) that are more prone to the deposition of cancerous cells due to presence of hematopoietic bone marrow, subdivision of local blood vessels and reduced velocity of blood flow. In fact, the formation of secondary foci of tumor colonization occurs by hematogenous dissemination of tumor emboli, that accumulate in regions with larger amounts of bone marrow and low circulatory velocity. In females, commonly seen metastatic lesions arise from primary neoplasms in breasts, colon, genitals and thyroid glands, whereas in males arise from lungs, prostate and colon region. Patients with metastatic jaw disease may be asymptomatic or may show various clinical signs and symptoms that include pain, swelling, paresthesia, foul smell, tooth mobility, exophytic growths of the soft tissues, reduced mouth opening and, infrequently, pathological fractures. In particular, metastasis in breast cancer is commonly seen in the lungs, liver, bones, pleura, brain, and kidneys, whereas breast cancer metastasis to the oral cavity is not common and is seen in only around 1% of the cases. Breast cancer can also be latent where the metastases appear years after treatment of the primary tumor. The presence of metastasis is highly important in determining the patient's prognosis and mode of treatment. The aim of the present article is to present and discuss the diagnosis of a breast cancer metastasis in the mandibular angle.

Keywords: Biopsy; Breast cancer; Diagnosis; Mandible; Metastasis.

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Conflict of interest statement

Conflict of interestThe authors have not disclosed any conflicts of interest.

Figures

Fig. 1
Fig. 1
Coronal (a) and axial (b) CT scan, performed in 2021, showing the absence of pathological images in correspondence of the mandible
Fig. 2
Fig. 2
Panoramic radiograph, performed in January 2023, revealing a dishomogeneous mixed radiopaque—radiotransparent in the left mandibular angle region distally to the inferior left second molar
Fig. 3
Fig. 3
Coronal (a) and axial (b,c) CT scan, performed in 2023, confirming the presence of an ill-defined radiotransparent osteolytic soft tissue density mass lesion in the left mandibular angle region. Erosion of both the lingual and vestibular cortical bone was found
See this image and copyright information in PMC

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