Metastatic prostate cancer presenting as trigeminal nerve paresthesia in the mandible

Metastatic disease to the oral cavity is rare and often presents with ambiguous symptoms and subtle or no radiographic changes. These factors make diagnosis challenging. This article describes a case of metastatic prostate cancer to the mandible that presented as altered sensation to the gingiva, lips, and chin without radiographic evidence of pathosis noted on standard dental imaging. At the time of presentation, the patient's prostate cancer, diagnosed 9 years previously, was thought to be well-controlled with medical therapy. With additional laboratory testing and medical imaging, widespread metastatic disease was discovered. This case reinforces the importance of including metastatic disease in the differential diagnosis as well as the utility of collaboration with providers outside dentistry.