title: Metastasis of hepatocellular carcinoma into the mandible with radiographic findings mimicking a radicular cyst: a case report.
abstract: 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.
authors: Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, Yokohama, Kanagawa, Japan. fujihara-h@tsurumi-u.ac.jp
authors: Hisako
authors: H
authors: Fujihara
authors: Daichi
authors: D
authors: Chikazu
authors: Hideto
authors: H
authors: Saijo
authors: Hideyuki
authors: H
authors: Suenaga
authors: Yoshiyuki
authors: Y
authors: Mori
authors: Mitsuyoshi
authors: M
authors: Iino
authors: Yoshiki
authors: Y
authors: Hamada
authors: Tsuyoshi
authors: T
authors: Takato
mesh_terms: 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