An unusual metastatic colo-rectal adenocarsinoma of the mandible

OpenAlex İngilizce

Metastatic colorectal adenocarcinoma to the mandible are rare and very unusual. We present a mandibular mass diagnosed as metastatic rectal adenocarcinoma as the first symptom of the disseminated disease. A 47-year-old woman presented to oral and maxillofacial surgery clinic with a 3-week history of a third molar extraction due to a disturbing pain and sporadic numbness over her lower lip followed by a rapidly growing swelling in her right mandibular angulus after the extraction. An orthopantomogram and Computed tomographic scan showed a well-defined 45 x 40 mm mass at her right mandibular angulus/ramus region. Destruction of the mandible was remarkable. An intrabony biopsy was performed. Pathologic examination of the specimen revealed a metastatic adenocarcinoma, most possibly from colorectal region. A PET Scan revealed rectal mass with metastases including both lungs, sacrum, iliac bone and L3 vertebra were also found. A colonoscopic biopsy of the rectal mass confirmed the diagnosis. Due to the poor prognosis of this widely disseminated disease, surgery was not considered and the patient was offered palliative chemotherapy and radiation therapy for the primary tumor and metastases. Rectal adenocarcinoma typically metastasizes to the liver, vertebraes and pelvis. Oral metastatic tumor from colorectal cancer is very uncommon, often found with advanced cancer and should be included in the differential diagnosis of tumors in the oral cavity. Palliative treatment including chemotherapy and radiotherapy is the usual therapeutic option. Unusual bony lesions should raise an awareness and induce the phsyician to suspect about metastatic tumors, including rectal carcinoma.