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Prostate adenocarcinoma mandibular metastasis associated with numb chin syndrome: a case report

Journal of the Korean Association of Oral and Maxillofacial Surgeons / Journal of the Korean Association of Oral and Maxillofacial Surgeons, (P)2234-7550; (E)2234-5930
2016, v.42 no.5, pp.301-306






Abstract

The purpose of this study is to report a rare case of mandibular adenocarcinoma that was diagnosed due to metastasis from the prostate. Numb chin syndrome (NCS), which was associated with this case, is also discussed. Computed tomography (CT) and an intraoral incisional biopsy of the left man-dibular area were performed. Urology consultation, hormone therapy, chemotherapy and follow-up radiographic images were administered. Histologi-cal examination of the incised specimen revealed moderately differentiated adenocarcinoma. The Gleason score was 8 (primary 4/secondary 4). Immu-nohistochemical features and radiographic results confirmed the diagnosis of metastasis from prostate adenocarcinoma, moderately differentiated. The patient’s prostate-specific antigen (PSA) level was very high. After hormone treatment, the patient’s PSA levels dropped gradually. Seventeen months later, in May 2015, the PSA level was elevated. The 18-month follow-up CT image indicated that the patient’s condition was aggravated. Docetaxel chemotherapy was started in June 2015 (18 months later), and the sixth cycle of the therapy is in progress. Oral metastases that originate from prostate adenocarcinoma are rare and can induce various periosteal reactions. Hormone therapy, chemotherapy and close follow-up could be additional, appro-priate treatment, and were applied in this case. Finally, NCS is a valuable indicator of metastatic disease in the mandible.

keywords
Prostate adenocarcinoma, Oral metastases, Hormone therapy, Chemotherapy, Numb chin syndrome

Journal of the Korean Association of Oral and Maxillofacial Surgeons