title: Numb chin syndrome as a sign of mandibular metastasis: A case report.
abstract: BACKGROUND
  Metastasis to the oral cavity can be located in both the soft and bony tissues and comprise only 1% of all oral malignancies; however, it is clinically significant because it indicates widespread metastatic disease and an unfavorable prognosis. A numb chin is an important presentation of oral metastasis, but other dental and systemic pathology may be involved.
  
  
  METHODS
  We present the case of a 54-year-old woman who presented with numb chin syndrome 8 years after a diagnosis of primary breast carcinoma. The former was caused by mandibular ramal metastasis of the tumor, which also spread to the spinal canal, ribs, pelvic bones, sacrum, and proximal femur. Because of widespread metastasis, palliative treatment was administered.
  
  
  CONCLUSIONS
  Despite its low incidence, oral metastasis should be considered as a diagnostic option when patients present with numb chin syndrome. Bony metastasis may produce symptoms late, in contrast to soft tissue metastasis. Pain is the first presenting symptom in most cases, but paresthesia, hypoesthesia and anesthesia in the facial region are possible symptoms too. Most oral bony metastasis are located in the mandible, especially in the molar region. Despite treatment, the average survival after diagnosis of mandibular metastasis is 6-7 months.
  
  
  CONCLUSIONS
  In most cases with oral metastasis, palliative treatment is indicated. Early detection of oral lesions could improve treatment outcome and survival. A full diagnostic work-up is therefore of great importance.
authors.affiliation: Maxillofacial Surgery Department, University Hospitals Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium. Electronic address: thomas.aerden@gmail.com.
authors.forename: Thomas
authors.initials: T
authors.lastname: Aerden
authors.affiliation: Maxillofacial Surgery Department, University Hospitals Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium.
authors.forename: Koenraad
authors.initials: K
authors.lastname: Grisar
authors.affiliation: Multidisciplinary Breast Center, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.
authors.forename: Patrick
authors.initials: P
authors.lastname: Neven
authors.affiliation: Department of Pathology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.
authors.forename: Esther
authors.initials: E
authors.lastname: Hauben
authors.affiliation: OMFS-IMPATH Research Group, Dept. Imaging & Pathology, Faculty of Medicine, University Leuven and Head of the Maxillofacial Surgery Department, University Hospitals Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium.
authors.forename: Constantinus
authors.initials: C
authors.lastname: Politis
keywords: Case report; Mandibular metastasis; Numb chin