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Metastatic Mandibular–Prostate Adenocarcinoma as the First Sign of an Advanced Stage Malignant Disease

2018; Elsevier BV; Volume: 126; Issue: 3 Linguagem: Inglês

10.1016/j.oooo.2018.02.049

2212-4411

MARCOS ANTONIO NUNES COSTA SILAMI, Rafael Cabral Da Costa, Hiran José Rodrigues Coelho, Jeannes Da Cunha Macedo, Priscila de Azeredo Lopes, Fabio Ramos Pires, Marco Aurélio Carvalho de Andrade,

Bone health and treatments

Prostate cancer, a neoplasm that commonly causes bony metastases, rarely involves the jaw. An 80-year-old man presented with complaints of pain and paresthesia on the right side of the mandible for 3 months. Anamnesis revealed systemic hypertension and prostatic hyperplasia. Clinical examination revealed a symptomatic nodule involving the right mandibular posterior region. Panoramic radiography and computed tomography analysis showed periosteal reaction at the inferior border of the right mandible. Provisional diagnosis included osteosarcoma and metastasis. Incisional biopsy was performed and the histologic/immunohistochemical diagnosis was compatible with metastatic prostate adenocarcinoma. The patient was referred to a tertiary center, and a prostate biopsy confirmed the diagnosis of prostate adenocarcinoma. Scintigraphy results revealed the involvement of costal arch, mandible, vertebrae, acetabulum, and humerus. The patient underwent orchiectomy and 20 months later is alive, with palliative treatment. This case highlights the importance of the dental sciences in the diagnosis of unknown primary malignant neoplasms.