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Mandibular Metastasis from Undiagnosed Hepatocellular Carcinoma - A Case Report
Guido Lobbia1, Silvia Difonzo1, Dario Ventorre2
1Department of Surgical Sciences, Dentistry, Gynaecology and Paediatrics, Section of Oral and Maxillofacial Surgery, University of Verona, Verona, Italy.
Rationale:
Cancer metastatic to the oral cavity accounts for 1%-4% of all oral malignancies, spreading from a distant primary site. Nevertheless, oral metastasis is often the first presentation of primary cancer.
Patient Concerns:
A 53-year-old male was referred to our institution because of painful swelling of the left parotid region that did not respond to medications. A firm mass extending towards the mandbular angle had caused trismus; furthermore, the patient complained about hypoesthesia in the V3 area. No noticeable findings could be seen intraorally.
Diagnosis:
Computed tomography imaging showed non-homogeneous post-contrast enhancement of the left vertical mandible branch; moreover, there were clear signs of bone erosion and swelling of the contiguous soft tissues.
Treatment:
Biopsy was performed under general anaesthesia, through a transoral approach.
Outcomes:
Histology and immunohistochemical analysis revealed hepatocellular carcinoma metastatis.
Take-Away Lessons:
In the differential diagnosis of oral neoplasms, metastasis coming from a distant site should always be taken into consideration.
