title: Metastatic melanoma misdiagnosed as a temporomandibular disorder: a case report and review of the literature.
abstract: BACKGROUND
  Malignancies in the head and neck region are difficult to diagnose because of their deep location and presence of symptoms mimicking those of temporomandibular disorders or other orofacial pain disorders.
  
  
  METHODS
  A 75-year-old woman reported experiencing right-sided jaw pain, temporal discomfort and paresthesia. She had undergone conservative therapy for temporomandibular joint disorder, which was unsuccessful. A magnetic resonance image of the midface revealed a mass on the base of the tongue along with possible metastatic lesions to the brain. Further investigation of the lesions revealed them to be metastatic melanoma.
  
  
  CONCLUSIONS
  Patients with atypical symptoms of facial pain, including neurological signs, should undergo further investigation with advanced imaging to determine the source of the symptoms, which could include neoplasms.
authors.affiliation: Dr. Singh is a resident, Oral and Maxillofacial Surgery, School of Dentistry, Virginia Commonwealth University, Richmond.
authors.forename: Samir
authors.initials: S
authors.lastname: Singh
authors.affiliation: Dr. Desai is an assistant professor, Oral Medicine, School of Dentistry, Virginia Commonwealth University, 1101 E. Leigh St., Richmond, Va. 23298, e-mail bdesai@vcu.edu. Address correspondence to Dr. Desai.
authors.forename: Bhavik
authors.initials: B
authors.lastname: Desai
authors.affiliation: Dr. Laskin is a professor and chairman emeritus, Department of Oral and Maxillofacial Surgery, School of Dentistry, Virginia Commonwealth University, Richmond.
authors.forename: Daniel
authors.initials: D
authors.lastname: Laskin
mesh_terms: D000368:Aged; D001932:Brain Neoplasms / Q000175:diagnosis / Q000556:secondary; D003951:Diagnostic Errors; D004433:Earache / Q000175:diagnosis; D005157:Facial Pain / Q000175:diagnosis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008545:Melanoma / Q000175:diagnosis / Q000556:secondary*; D010292:Paresthesia / Q000175:diagnosis; D049268:Positron-Emission Tomography / Q000379:methods; D013702:Temporal Lobe / Q000473:pathology; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis*; D014062:Tongue Neoplasms / Q000175:diagnosis*
keywords: Oral medicine; metastatic melanoma; neoplasms; orofacial; pain; temporomandibular joint disorders