[Mental neuropathy and pathologic fracture of the mandible as initial symptoms of metastatic prostate carcinoma].
BACKGROUND
Distant metastases of solid tumors account for about 1% of all malign neoplasms. In about 30% of all patients who present with an oral metastasis, the distant primary tumour has not been diagnosed yet.


METHODS
We report the case of a 71-year-old man who clinically demonstrated unilateral mental neuropathy as well as pathologic fracture of the mandible. Prostate carcinoma was identified as a primary tumor. Clinically, there was significant hypesthesia of the skin area innervated by the left inferior alveolar nerve. X-ray examination revealed an osteolytic lesion of the ascending ramus of the mandible as well as a pathologic fracture of the mandible. Further imaging showed an extensive neoplasm of the mandible and adjacent soft tissues and significant supraclavicular lymph node enlargement. The diagnosis of metastatic carcinoma of the prostate was histopathologically confirmed.


CONCLUSIONS
Mental neuropathy without a dental focus indicates screening for an osseous metastasis. In cases of left-sided supraclavicular lymph node enlargement in men over 45 years, metastatic prostate carcinoma must be excluded.
Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Universitätsklinikum Tübingen, Tübingen. juergen.hoffmann@uni-tuebingen.de
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Polligkeit
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Westendorff
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Kröber
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Zerfowski
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Hoffmann
D000368:Aged; D001706:Biopsy; D003937:Diagnosis, Differential; D005598:Fractures, Spontaneous / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008334:Mandible / Q000294:innervation*; D008337:Mandibular Fractures / Q000175:diagnosis* / Q000473:pathology; D008339:Mandibular Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary*; D008340:Mandibular Nerve / Q000473:pathology / Q000503:physiopathology*; D008410:Masticatory Muscles / Q000473:pathology; D010292:Paresthesia / Q000175:diagnosis* / Q000473:pathology; D011467:Prostate / Q000473:pathology; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology; D011862:Radiography, Panoramic; D014057:Tomography, X-Ray Computed