@article{3111777,
    title = "Metastatic breast carcinoma in the mandible presenting as a periodontal abscess: A case report",
    author = "Poulias, E. and Melakopoulos, I. and Tosios, K.",
    journal = "Journal of Medical Case Reports",
    year = "2011",
    volume = "5",
    publisher = "BioMed Central Ltd.",
    issn = "1752-1947",
    doi = "10.1186/1752-1947-5-265",
    keywords = "estrogen receptor;  ibandronic acid;  medronate technetium tc 99m;  tamoxifen, adult;  alveolar bone loss;  article;  breast biopsy;  cancer diagnosis;  cancer hormone therapy;  case report;  chronic periodontitis;  cone beam computed tomography;  dentition;  differential diagnosis;  disease association;  female;  follow up;  histology;  human;  inflammation;  intraductal carcinoma;  jaw osteonecrosis;  lymph node dissection;  mastectomy;  medical history;  mouth mucosa;  oral paresthesia;  osteomyelitis;  palliative therapy;  palpation;  periodontal abscess;  periodontal pocket;  priority journal;  radiation dose fractionation;  radiography;  tooth calculus;  tooth plaque",
    abstract = "Introduction. Tumors can metastasize to the oral cavity and affect the jaws, soft tissue and salivary glands. Oral cavity metastases are considered rare and represent approximately 1% of all oral malignancies. Because of their rarity and atypical clinical and radiographic appearance, metastatic lesions are considered a diagnostic challenge. The purpose of this report is to present a rare case of a metastatic breast carcinoma mimicking a periodontal abscess in the mandible. Case presentation. A 55-year-old Caucasian woman was referred to our clinic for evaluation of bisphosphonate-induced jaw osteonecrosis. She had undergone modified radical mastectomy with axillary lymph node dissection for invasive ductal carcinoma of the left breast. Her clinical examination showed diffuse swelling and a periodontal pocket of 6 mm exhibiting suppuration in the posterior right mandible. Moreover, paresthesia of the lower right lip and chin was noted. There were no significant radiographic findings other than alveolar bone loss due to her periodontal disease. Although the lesion resembled a periodontal abscess, metastatic carcinoma of the breast was suspected on the basis of the patient's medical history. The area was biopsied, and histological analysis confirmed the final diagnosis of metastatic breast carcinoma. Conclusion: The general dentist or dental specialist should maintain a high level of suspicion while evaluating patients with a history of cancer. Paresthesias of the lower lip and the chin should be considered ominous signs of metastatic disease. This case highlights the importance of the value of a detailed medical history and thorough clinical examination for the early detection of metastatic tumors in the oral cavity. © 2011 Poulias et al."
}