Prostate cancer presenting as an oral swelling-A case report

Tumour metastasis to the jaw is an uncommon finding. When it does present, it is usually evidence of widespread metastatic disease and represents an unfavourable prognostic indicator. The clinical presentation of metastatic disease in the jaw can vary and may occur in the oral soft tissues, subcutaneous tissues adjacent to bone, mandible or maxillary alveolus and can mimic dental pathology. The radiographic appearance of metastatic disease is most commonly an expansive, lytic lesion with irregular borders. This case report describes the presentation of an otherwise medically well 76-year-old male patient to his dentist with a mobile lower left pre-molar. Following extraction of the tooth, a rapid increase in the jaw swelling resulted in further medical investigation, leading to a diagnosis of metastatic prostate cancer. This case serves to remind dental practitioners to remain vigilant when dental treatment of seemingly obvious dental pathology does not resolve within the expected timeframe, and to maintain a low threshold for medical review and investigation when suspicious lesions arise. This is particularly relevant in the older patient when the incidence of other diseases, such as cancer, is more common.