Abstract
The reported case is of a 57-year-old female patient with metastatic breast cancer in liver, pleura, and bones treated with eribulin without antiresorptives and sent for assessment of submandibular abscess after extraction of tooth 37 two months before. The examination showed increased volume in the buccal vestibule, retromolar trigone region, and left buccal mucosa without mucosal lesions, palpation hardening, or facial asymmetry. Tomography showed heterogeneous expansive lesion with peripheral enhancement and necrotic center in the left mandibular angle and branch (60 × 49 × 54 mm) with infiltration of the masticatory musculature and osteolysis of the posterior wall of the left maxillary sinus. Incisional biopsy results revealed a poorly differentiated neoplasm, confirming squamous cell carcinoma after an immunohistochemical study. The initial diagnostic hypothesis of bone metastasis was surprisingly challenged by a second primary tumor. Faced with the systemic condition, the patient progressed to palliative care evolving to death less than 2 months after diagnosis. The reported case is of a 57-year-old female patient with metastatic breast cancer in liver, pleura, and bones treated with eribulin without antiresorptives and sent for assessment of submandibular abscess after extraction of tooth 37 two months before. The examination showed increased volume in the buccal vestibule, retromolar trigone region, and left buccal mucosa without mucosal lesions, palpation hardening, or facial asymmetry. Tomography showed heterogeneous expansive lesion with peripheral enhancement and necrotic center in the left mandibular angle and branch (60 × 49 × 54 mm) with infiltration of the masticatory musculature and osteolysis of the posterior wall of the left maxillary sinus. Incisional biopsy results revealed a poorly differentiated neoplasm, confirming squamous cell carcinoma after an immunohistochemical study. The initial diagnostic hypothesis of bone metastasis was surprisingly challenged by a second primary tumor. Faced with the systemic condition, the patient progressed to palliative care evolving to death less than 2 months after diagnosis.
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