Mandibular metastasis of pulmonary adenocarcinoma: How unexpected could it be?

Objective: Metastatic tumours of bone must be considered in all patients with unex-plained bone pain and particularly in patients who present with a known cancer, lo-calised pain at multiple sites, and radiographic findings suggestive of metastasis. The purpose of this report was to present a case of a pathological fracture of the mandible as a consequence of metastatic pulmonary adenocarcinoma.Materials and Methods: In July 2018 a 68- year- old male patient was hospitalised because of pulmonary adenocarcinoma and attended our department for an oral maxillo- facial evaluation. He complained of pain and swelling in the right temporo-mandibular region resulting in a reported functional limitation.An Orthopantomogram (OPG) demonstrated a right intracapsular condylar compound fracture associated with an osteolytic lesion at the condyle base with jagged margins. Subsequently, a CT scan with contrast of the maxillo- facial complex and a fine- needle aspiration of the lesion was performed.Results: CT images showed the presence of a right mandibular condyle fracture as-sociated with a large osteolytic lesion which confirmed the pathological nature of the fracture. Fine- needle aspiration of the lesion confirmed its metastatic nature. It was not possible to proceed with a mandibular resection due to the critical clinical condi-tion of the patient who died in September 2018.Conclusion: Lung cancer frequently produces lytic- type metastasis, sometimes even in the jaw. In patients with an established diagnosis of lung cancer, any radiolucent lesion of the jaw or an unexplained painful symptomatology to the oro- maxillo facial complex should be placed in differential diagnosis with metastasis of the primary tumour.