Lu S Y, Chen L
Kaohsiung Medical Center, Taiwan, ROC.
Zhonghua Ya Yi Xue Hui Za Zhi. 1991 Sep;10(3):98-103.
A case is presented in which the only positive subjective and clinical findings were numbness of the lower lip and chin, generalized tooth mobility with dull pain, and swelling of the right lower jaw. After an appropriate and careful workup, in conjunction with other medical colleagues, a definitive diagnosis of adenocarcinoma of breast metastasis to the mandible was made, which was confirmed by a histopathologic examination. Radiographs disclosed radiolucent change with an irregular and a moth-eaten appearance in the mandibular trabeculation and loss of the lamina dura of several teeth. As this case demonstrates, the diagnosis of metastatic disease of the jaws requires a high degree of diagnostic astuteness, because of the many possible clinical signs and symptoms which can be nonspecific and can resemble diseases of an inflammatory origin. Accordingly, a histologic evaluation is essential in establishing a definitive diagnosis. The case report emphasizes the need for consideration of metastatic disease in the differential diagnosis of unknown oral lesions, especially in the mandible.
本文报告了一例病例，其唯一的主观症状和临床发现为下唇及颏部麻木、牙齿普遍松动伴钝痛以及右下颌肿胀。经过适当且仔细的检查，并与其他医学同事协作，最终诊断为乳腺癌转移至下颌骨的腺癌，这一诊断通过组织病理学检查得以证实。X线片显示下颌骨小梁出现透射性改变，呈不规则且虫蚀状外观，数颗牙齿的硬骨板消失。正如该病例所示，颌骨转移性疾病的诊断需要高度的诊断敏锐性，因为可能出现的临床体征和症状众多，且可能不具特异性，类似炎症性疾病。因此，组织学评估对于明确诊断至关重要。该病例报告强调，在不明口腔病变的鉴别诊断中，尤其是在下颌骨病变时，需要考虑转移性疾病。
