Lytic lesion of the mandible revealing a metastatic breast cancer.

introduction and importanceBreast cancer is the most common cancer in women and the second leading cause of cancer-related death. Breast cancer manifestations in the head and neck are relatively rare, have greater predilection for the jaws than for soft tissues. Metastasis in the oral cavity account for only 1 to 3 % of all oral malignant lesions. Regardless of the rare occurrence of metastatic lesions to the jaw, it should be taken into consideration in the individuals with a history of malignancy. CASE PRESENTATION: The article reports a rare case of metastatic lesion of breast cancer to unilateral mandibular ramus region. The 66-year-old female patient was complaining of pain and swelling in the right mandible angle. She was referred to our department by her oncologist with the differential diagnosis of osteonecrosis or metastasis. She had undergone radical mastectomy for invasive lobular carcinoma of the left breast without adjuvant treatment. Oral cavity examination did not reveal the existence of any ulcer or fistula. Based on the patient's medical history and paresthesia of the lower lip and chin, the metastatic disease was highly suspected. The patient was referred to her oncologist for chemotherapy treatment before any invasive surgical management. CLINICAL DISCUSSION: Breast cancer (BC) is the most common cancer affecting women globally. Bone is the most common site of metastasis in BC patients, with up to 75 % of stage IV BC patients developing skeletal metastasis. The frequent metastatic sites of bone are spine, ribs, sternum, femur, pelvis. Breast carcinoma metastasizes to the jaw bones are uncommon.

conclusionThe diagnosis of metastasis to the oral cavity is a significant challenge to the clinician due to the lack of pathognomonic signs and symptoms. The general dentist or dental specialist should maintain a high level of suspicion while dealing patients with a history of cancer.