Metastatic adenocarcinoma of mandible: in search of the primary

• Published in: BMJ case reports Vol. 11; no. 1; p. e227862
• Main Authors: Savithri, Vindhya, Suresh, Rakesh, Janardhanan, Mahija, Aravind, Thara
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 14.12.2018; BMJ Publishing Group
• Series: Case Report
• Subjects: Adenocarcinoma of Lung - diagnostic imaging; Adenocarcinoma of Lung - pathology; Carcinoma, Renal Cell - diagnostic imaging; Carcinoma, Renal Cell - secondary; Case reports; Facial Pain - diagnostic imaging; Facial Pain - etiology; Facial Pain - pathology; Female; Gallbladder Neoplasms - diagnostic imaging; Gallbladder Neoplasms - secondary; Head & neck cancer; Humans; Jaw; Kidneys; Lungs; Lymphatic system; Mandible - diagnostic imaging; Mandible - pathology; Mandibular Neoplasms - diagnostic imaging; Mandibular Neoplasms - secondary; Medical prognosis; Metastasis; Middle Aged; Pain; Palliative care; Positron Emission Tomography Computed Tomography; Prognosis; Radiation therapy; Reminder of Important Clinical Lesson; Thyroid gland; Tooth Extraction; Transcription factors; Tumors; Vertebrae; Whole Body Imaging; head and neck cancer; dentistry and oral medicine; pathology
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2018-227862

We present here a case of a 64-year-old female patient who reported with a complaint of pain in the chin region of 3-month duration. The radiographs revealed an irregular radiolucent lesion in the anterior part of the mandible. An incisional biopsy was carried out and the microscopy showed features of adenocarcinoma. Suspecting a metastatic lesion, the patient was then sent for whole body examination which showed a mass in the lungs. A whole body scan also showed metastasis to other organs such as kidney, gallbladder and vertebrae. This case is unusual in that the patient complained only of a vague jaw pain with no other systemic symptoms even in the presence of widespread disease.