Abstract

Metastasis to the oral cavity represents 1% of all tumors in this location, and the molar area of the mandible is the most common region of metastasis. Tumors that metastasize to the oral cavity have clinical characteristics that can mimic reactive or inflammatory lesions, making their diagnosis a clinical challenge.

We present a case of a 30-year-old female patient, with breast adenocarcinoma with lymph node and bone metastasis, who underwent chemotherapy, mastectomy and had been under therapy with zoledronic acid. The patient had pain in the left hemiface region, and mandibular bone exposure at the extraction site of tooth 37. The radiography showed massive bone sequestration in the posterior left mandibular body, distally to tooth 36. The main diagnostic hypothesis was Medication-Related Osteonecrosis of the Jaws (MRONJ). The biopsy revealed a metastasis of the previously diagnosed breast cancer. The patient was treated with palliative care and died six months after the biopsy.

Being an uncommon diagnosis, necrotic lesions in metastatic cancer of the oral cavity can be misinterpreted as MRONJ in patients with history of antiresorptive medication. A biopsy prior to treatment is essential once it changes the therapeutic strategy of these patients.

Keywords

• Bisphosphonate-Associated Osteonecrosis of the Jaw
• Neoplasm Metastasis
• Drug-Related Side Effects and Adverse Reactions
• Diagnosis

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Categories

• Oral Surgery
• Head and Neck Oncology
• Oral Medicine

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