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Referral details

Case 166874

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Referral category

Facial or muscle pain / paralysis / unusual sensations

Region of interest

Lower left mandible

Referral reason

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1 Files Info

Canaray 166874

1. Malignancy in posterior left mandible

An ill-defined radiolucent multilocular lesion is present in the posterior left mandibular body in the region apical to teeth 37 and 38. The root apices of tooth 38 appear to have been secondarily affected, but are not the source of any pathology. This entity has perforated through the walls of the inferior alveolar nerve canal, and has effaced the lingual cortical plate in the region apical to tooth 37. A moth-eaten appearance is present at the endosteal surfaces of the buccal and lingual cortical plates. This radiographic appearance is consistent with a malignancy, and most likely represents metastatic breast cancer, based on the patient's history of breast cancer. This lesion is the source of the numbness in the patient's lower left chin.

Left inferior alveolar nerve canal path shown in red overlay

The left inferior alveolar nerve canal is overlaid on these images of the posterior left mandibular body. Note the complete envelopment of the canal by the radiolucent malignant lesion in the posterior left mandibular body in the region apical to tooth 38.