Mandibular Metastasis from Undiagnosed Hepatocellular Carcinoma - A Case Report

Rationale: Cancer metastatic to the oral cavity accounts for 1%–4% of all oral malignancies, spreading from a distant primary site. Nevertheless, oral metastasis is often the first presentation of primary cancer. Patient Concerns: A 53-year-old male was referred to our institution because of painful swelling of the left parotid region that did not respond to medications. A firm mass extending towards the mandbular angle had caused trismus; furthermore, the patient complained about hypoesthesia in the V3 area. No noticeable findings could be seen intraorally. Diagnosis: Computed tomography imaging showed non-homogeneous post-contrast enhancement of the left vertical mandible branch; moreover, there were clear signs of bone erosion and swelling of the contiguous soft tissues. Treatment: Biopsy was performed under general anaesthesia, through a transoral approach. Outcomes: Histology and immunohistochemical analysis revealed hepatocellular carcinoma metastatis. Take-away Lessons: In the differential diagnosis of oral neoplasms, metastasis coming from a distant site should always be taken into consideration.