title: Unilateral face swelling as first manifestation of metastatic pancreatic cancer: case report and review of the literature.
abstract: OBJECTIVE
  Metastasis to the jaw is a rare finding in pancreatic cancer; only five cases of tumor spread to the oral region have been described.
  
  
  METHODS
  We report on a previously healthy 54-year-old man who attended the hospital in 2006 because of a mandibular mass. Histology was positive for adenocarcinoma and computed tomography led to the diagnosis of pancreatic cancer. Chemoradiotherapy was started but had to be stopped early because of intraoral bleeding from the metastasis. The patient subsequently received palliative chemotherapy. The primary cancer was stabilized but the mandibular mass progressed despite cytostatic therapy. Despite best supportive measures the patient died nine months after presentation.
  
  
  CONCLUSIONS
  In making the decision on whether metastasectomy should be performed in an uncommon site of metastatic spread such as the mandibula, both the possibility of cure and also the potentially decreased response to conservative therapy and the patient's decreased quality of life have to be considered.
authors.affiliation: Department of Internal Medicine I and Cancer Center, Medical University of Vienna, Vienna, Austria.
authors.forename: Laurenz
authors.initials: L
authors.lastname: Vormittag
authors.forename: Boban
authors.initials: B
authors.lastname: Erovic
authors.forename: Christian
authors.initials: C
authors.lastname: Schopper
authors.forename: Christoph C
authors.initials: CC
authors.lastname: Zielinski
authors.forename: Gabriela
authors.initials: G
authors.lastname: Kornek
authors.forename: Dietmar
authors.initials: D
authors.lastname: Thurnher
mesh_terms: D000230:Adenocarcinoma / Q000209:etiology* / Q000556:secondary* / Q000628:therapy; D004487:Edema / Q000175:diagnosis / Q000209:etiology*; D005145:Face; D006801:Humans; D008297:Male; D008339:Mandibular Neoplasms / Q000150:complications* / Q000556:secondary* / Q000628:therapy; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000628:therapy*