Mandibular metastasis of primary extrahepatic biliary carcinoma: Case report.

Abstract

Introduction and importanceCholangiocarcinoma is a malignant neoplasm with a difficult diagnosis and unfavorable prognosis that can appear anywhere in the biliary tree. Anatomically, it can be classified as intra- or extrahepatic, the latter being the most common primary malignancy of the biliary tract. Although bone tissue is the third most common target for metastases in general, metastatic lesions from cholangiocarcinomas are uncommon in the head and neck.Case presentationA 33-year-old female patient undergoing cancer treatment for cholangiocarcinoma was referred to the Oral and Maxillofacial Surgery and Traumatology Service (CTBMF) of the São Vicente de Paulo Hospital in Passo Fundo, Rio Grande do Sul, Brazil, for interdisciplinary follow-up. She presented trismus, dysphagia, pain, necrosis and drainage in the mental region, and an increased volume on the right side of the mandibular body in the region of teeth 47 and 48. An incisional biopsy was performed in this bulging region. The histopathological diagnosis was poorly differentiated carcinoma. The patient was followed-up weekly by the CTBMF team, receiving analgesia and palliative treatment for the extra- and intraoral lesions, controlling opportunistic infections, and improving food intake.DiscussionMetastatic cholangiocarcinomas in the mandible are rare, hence their diagnosis is often late, which may disfavor the prognosis of these conditions.ConclusionCarefully examining patients with mandibular bone lesions is strongly suggested, especially patients with known or previous concomitant malignancy.