Mandibular swelling as the initial presentation for renal cell carcinoma: A case report

Area of Science:

• Oncology
• Oral and Maxillofacial Surgery
• Nephrology

Background:

• Renal cell carcinoma (RCC) is the most common kidney malignancy, often presenting asymptomatically or with advanced disease.
• Metastatic spread occurs in up to a third of RCC patients at diagnosis.
• Mandibular involvement by RCC is rare, with few documented cases.

Observation:

• A 56-year-old female presented with a 3-month history of right-sided mandibular swelling, pain, and paraesthesia.
• Imaging revealed a destructive lesion of the right mandible, involving the condyle, coronoid, and ramus.
• Biopsy confirmed metastatic renal cell carcinoma.

Findings:

• Computed tomography (CT) identified a primary tumor in the right kidney.
• The advanced stage of the disease precluded curative treatment.
• The patient received palliative care and passed away 11 months post-diagnosis.

Implications:

• Orofacial symptoms, such as mandibular swelling, can be the first clinical manifestation of systemic malignancy.
• Persistent orofacial swellings, especially those associated with cranial nerve deficits and without clear infection, warrant thorough investigation for underlying systemic disease.
• This case underscores the importance of a multidisciplinary approach in diagnosing and managing rare metastatic presentations of renal cell carcinoma.