Metastatic hepatocellular carcinoma to the mandible with an initial symptom of lower lip hypesthesia: Report of a case and review of the literature

Metastatic tumors in the oral and maxillofacial region are relatively infrequent. The common primary organs of neoplasm that metastasize to the jawbone are breast, lung and adrenal, in decreasing order of frequency. Therefore, metastasis of liver neoplasm to the mandible with aninitial symptom in the oral cavity is extremely rare. A case of metastatic hepatocellular carcinoma with the initial symptom of lower lip hypesthesia, was encountered and the clinical course is reported along with a review of the literatures of metastatic liver tumors of the mandible. After consultation of the dentist, anesthesiologist, otorhinolaryngologist, and neurologist, the patient, a 59-year-old male, was referred to our clinic. Radiological findings of the bone adjacent to the first premolar of the mandible showed slightly diffuse absorption. The pathohistological findings of the biopsy specimen showed metastatic htaptocellular carci-noma of the mandible. In case of metastatic liver neoplasm in the oral region, many reports indicated that the initial symptoms were swelling and bleeding. However, the literatures from 1957 to 1996 concerning metastatic hepatocellular carcinoma of the mandible revealed that 5 of 27 cases showed sensory disturbance of the trigeminal nerve. Furthermore, the most frequent age and sex were 50 years old and male, and the highest incidence was found in the body and ramus of the mandible.