Mandibular Metastasis From Colon Cancer Presenting as Jaw Pain

Colorectal cancer (CRC) may rarely present with atypical symptoms, particularly in the context of metastatic disease. While the most common sites of metastasis include the liver, lungs, peritoneum, and lymph nodes, osseous metastases are uncommon, and mandibular involvement is exceedingly rare. We report a case of a 57-year-old male who presented with several weeks of isolated jaw pain. Imaging revealed a destructive mass in the right mandible, and histopathology confirmed metastatic adenocarcinoma of colorectal origin. Abdominal imaging and colonoscopy identified a fungating, partially obstructing sigmoid mass with synchronous liver metastases. Due to extensive disease, surgical resection was not pursued. The patient was initiated on systemic chemotherapy with folinic acid, 5-fluorouracil, and oxaliplatin (FOLFOX) and bevacizumab, with early biochemical and clinical response. This case demonstrates that oral metastasis of CRC portends a poor prognosis. Therefore, high clinical suspicion, timely diagnosis, and initiation of systemic therapy are essential to optimize patient outcomes and maintain quality of life.