Metastatic ductal breast carcinoma to the mandible: case report and review of the literature

Juan Pablo Rodríguez-Mora; Lina María Zambrano-Luque; Ana Karina Sarmiento-Liévano; Claudia Patricia Peña-Vega

doi:10.5327/2525-5711.365

Authors

Juan Pablo Rodríguez-Mora Universidad Nacional de Colombia, School of Dentistry – Bogotá, Colombia. https://orcid.org/0009-0009-3198-1861
Lina María Zambrano-Luque Universidad Nacional de Colombia, School of Dentistry – Bogotá, Colombia. https://orcid.org/0009-0008-6862-6129
Ana Karina Sarmiento-Liévano Universidad Nacional de Colombia, School of Dentistry – Bogotá, Colombia. https://orcid.org/0000-0001-7313-3937
Claudia Patricia Peña-Vega Universidad Nacional de Colombia, School of Dentistry – Bogotá, Colombia. https://orcid.org/0000-0002-4532-3642

DOI:

https://doi.org/10.5327/2525-5711.365

Keywords:

Breast cancer, Metastasis, Bone metastasis, Mandible, Immunohistochemistry

Abstract

Mandibular metastasis is uncommon, representing about 1% of all head and neck metastatic bone tumors. Diagnosis is challenging due to variable clinicopathological and radiographic features. Immunohistochemistry can assist in identifying the tumor’s primary origin. We report on a 78-year-old woman with a history of left breast invasive ductal carcinoma (TXNXM0, Stage IIB, ER 100%, PR 5%, HER2-negative) and right ductal carcinoma in situ. A comprehensive diagnostic workup, including immunohistochemistry analysis, confirmed a metastatic ductal breast carcinoma to the mandible. The patient received chemotherapy at the Hospital Universitario Nacional de Colombia. Despite treatment, she passed away in December 2022 due to advanced systemic disease. This case illustrates the importance of a thorough diagnostic approach in maxillofacial metastasis to confirm origin, guide prognosis, and initiate timely treatment. Currently, multidisciplinary management is essential to reduce morbidity and improve patient’s quality of life.

References

Ganesh K, Massagué J. Targeting metastatic cancer. Nat Med. 2021;27(1):34-44. https://doi.org/10.1038/s41591-020-01195-4

Fares J, Fares MY, Khachfe HH, Salhab HA, Fares Y. Molecular principles of metastasis: a hallmark of cancer revisited. Signal Transduct Target Ther. 2020;5(1):28. https://doi.org/10.1038/s41392-020-0134-x

Clézardin P, Coleman R, Puppo M, Ottewell P, Bonnelye E, Paycha F, et al. Bone metastasis: mechanisms, therapies, and biomarkers. Physiol Rev. 2021;101(3):797-855. https://doi.org/10.1152/physrev.00012.2019

International Agency for Research on Cancer. WHO Classification of Tumours. Head and neck tumours. 5th ed. Lyon: WHO; 2022.

Hirshberg A, Berger R, Allon I, Kaplan I. Metastatic tumors to the jaws and mouth. Head Neck Pathol. 2014;8(4):463-74. https://doi.org/10.1007/s12105-014-0591-z

Labrador AJP, Marin NRG, Valdez LHM, Sanchez KBT, Zabarburu W, Ibazetta KAR, et al. Metastasis to the oral and maxillofacial region. A systematic review. J Stomatol Oral Maxillofac Surg. 2022;123(5):e474-83. https://doi.org/10.1016/j.jormas.2021.12.009

Martins FMC, Henriques Neto T, Martins SP, Mendes RB. Metastasis to the oral cavity and jaw bones – a literature review about a case. Oral Oncol. 2023;137:106276. https://doi.org/10.1016/j.oraloncology.2022.106276

Raffaelli SD, Shupak RP, Winstead M, Hockaday JJ, Kim RY. A rare incidence of mandibular metastasis of papillary thyroid carcinoma: a case report and review of literature. J Stomatol Oral Maxillofac Surg. 2023;124(6S):101560. https://doi.org/10.1016/j.jormas.2023.101560

Yang HL, Liu T, Wang XM, Xu Y, Deng SM. Diagnosis of bone metastases: a meta-analysis comparing 18FDG PET, CT, MRI and bone scintigraphy. Eur Radiol. 2011;21(12):2604-17. https://doi.org/10.1007/s00330-011-2221-4

Cook GJ, Goh V. Functional and hybrid imaging of bone metastases. J Bone Miner Res. 2018;33(6):961-72. https://doi.org/10.1002/jbmr.3444

Kaplan I, Raiser V, Shuster A, Shlomi B, Rosenfeld E, Greenberg A, et al. Metastatic tumors in oral mucosa and jawbones: unusual primary origins and unusual oral locations. Acta Histochem. 2019;121(8):151448. https://doi.org/10.1016/j.acthis.2019.151448

Kimura TC, Henschel FAN, Carneiro MC, Santin GC, Veltrini VC. Oral metastasis as the first indication of undiscovered malignancy at a distant site: a systematic review of 413 cases. Head Neck. 2022;44(7):1715-24. https://doi.org/10.1002/hed.27041

Wick MR. Metastases to bones. Semin Diagn Pathol. 2014;31(1):53-65. https://doi.org/10.1053/j.semdp.2013.12.001

Burkhardt R, Frisch B, Schlag R, Sommerfeld W. Carcinomatous osteodysplasia. Skeletal Radiol. 1982;8(3):169-78. https://doi.org/10.1007/BF00355501

Rezaei N, Steinlein O, Rosenhouse-Dantsker A, Gerlai R. Advances in experimental medicine and biology. In: Ahmad A, editor. Breast cancer metastasis and drug resistance. New York: Springer International Publishing; 2019. https://doi.org/10.1007/978-3-030-20301-6

Yang W, Pan Q, Huang F, Hu H, Shao Z. Research progress of bone metastases: from disease recognition to clinical practice. Front Oncol. 2023;12:1105745. https://doi.org/10.3389/fonc.2022.1105745