Metastasis of hepatocellular carcinoma into the mandible with radiographic findings mimicking a radicular cyst: a case report.
BACKGROUND
Hepatocellular carcinoma (HCC) is a common neoplasm worldwide, with more than half of the tumors associated with regional metastasis. Extrahepatic metastasis is also common, and the most frequently affected sites are the lungs, abdominal lymph nodes, diaphragm, and bone. However, HCC metastasis to the mandible is rare, with approximately 50 cases reported in the literature.


METHODS
In this report, we describe a case of HCC metastasis to the mandible at the apex of #18 root in a 62-year-old man. This patient had already been diagnosed with metastasis to pancreatic caput lymph node. The radiographic features of the mandible resembled radicular cyst and did not show typical findings of malignancy.


RESULTS
Under the first diagnosis of radicular cyst, root canal treatment was initially performed, and then surgical treatment of the removal of the cystic lesion and #18 extraction were performed. Finally, the lesion was diagnosed as HCC metastasis from pathological examination. Consequently, he received constitutional chemotherapy in the hepatitis unit and is now in remission.


CONCLUSIONS
This case shows the importance of considering the differential diagnosis of malignancy.
Fujihara
Hisako
H
Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, Yokohama, Kanagawa, Japan. fujihara-h@tsurumi-u.ac.jp
Chikazu
Daichi
D
Saijo
Hideto
H
Suenaga
Hideyuki
H
Mori
Yoshiyuki
Y
Iino
Mitsuyoshi
M
Hamada
Yoshiki
Y
Takato
Tsuyoshi
T
D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D003937:Diagnosis, Differential; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D008297:Male; D008339:Mandibular Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D008875:Middle Aged; D011842:Radicular Cyst / Q000000981:diagnostic imaging / Q000473:pathology*; D011859:Radiography; D016896:Treatment Outcome