{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T17:29:47Z","timestamp":1786728587061,"version":"build-2736575974"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale:<\/jats:title>\n                    <jats:p>Cancer metastatic to the oral cavity accounts for 1%\u20134% of all oral malignancies, spreading from a distant primary site. Nevertheless, oral metastasis is often the first presentation of primary cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient Concerns:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Diagnosis:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Treatment:<\/jats:title>\n                    <jats:p>Biopsy was performed under general anaesthesia, through a transoral approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes:<\/jats:title>\n                    <jats:p>Histology and immunohistochemical analysis revealed hepatocellular carcinoma metastatis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Take-away Lessons:<\/jats:title>\n                    <jats:p>In the differential diagnosis of oral neoplasms, metastasis coming from a distant site should always be taken into consideration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ams.ams_98_25","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T19:00:10Z","timestamp":1768849210000},"page":"265-268","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Mandibular Metastasis from Undiagnosed Hepatocellular Carcinoma - A Case Report"],"prefix":"10.4103","volume":"15","author":[{"given":"Guido","family":"Lobbia","sequence":"first","affiliation":[{"name":"Department of Surgical Sciences, Dentistry, Gynaecology and Paediatrics, Section of Oral and Maxillofacial Surgery, University of Verona, Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Difonzo","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Dentistry, Gynaecology and Paediatrics, Section of Oral and Maxillofacial Surgery, University of Verona, Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Ventorre","sequence":"additional","affiliation":[{"name":"Unit of Maxillofacial Surgery, Santa Chiara Regional Hospital, Trento, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Decaminada","sequence":"additional","affiliation":[{"name":"Unit of Maxillofacial Surgery, Santa Chiara Regional Hospital, Trento, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"D\u2019Agostino","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Dentistry, Gynaecology and Paediatrics, University of Verona, Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Trevisiol","sequence":"additional","affiliation":[{"name":"Unit of Maxillofacial Surgery, Santa Chiara Regional Hospital, Trento, Italy"},{"name":"Centre for Medical Sciences, University of Trento, Trento, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"R1-20260127","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1038\/s41572-020-00240-3","article-title":"Hepatocellular carcinoma","volume":"7","author":"Llovet","year":"2021","journal-title":"Nat Rev Dis Primers"},{"key":"R2-20260127","doi-asserted-by":"crossref","first-page":"2050313X231211709","DOI":"10.1177\/2050313X231211709","article-title":"Unusual sites of hepatocellular carcinoma metastasis: Case report","volume":"11","author":"Chaudhry","year":"2023","journal-title":"SAGE Open Med Case Rep"},{"key":"R3-20260127","first-page":"88","article-title":"Mandibular metastasis as the first manifestation of hepatocellular carcinoma: A case report","volume":"16","author":"Fern\u00e1ndez-Ferreira","year":"2023","journal-title":"Case Rep Oncol"},{"key":"R4-20260127","doi-asserted-by":"crossref","first-page":"1992","DOI":"10.3390\/medicina59111992","article-title":"A rare case of isolated hepatocellular carcinoma metastasis in left mandibular region in a patient with hepatitis C virus liver cirrhosis diagnosed after the onset of COVID-19 infection","volume":"59","author":"Ma\u0161ulovi\u0107","year":"2023","journal-title":"Medicina (Kaunas)"},{"key":"R5-20260127","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.jclinepi.2017.04.026","article-title":"CARE guidelines for case reports: Explanation and elaboration document","volume":"89","author":"Riley","year":"2017","journal-title":"J Clin Epidemiol"},{"key":"R6-20260127","doi-asserted-by":"crossref","first-page":"286","DOI":"10.3857\/roj.2019.00479","article-title":"Radiotherapy for mandibular metastases from hepatocellular carcinoma: A single institutional experience","volume":"37","author":"Park","year":"2019","journal-title":"Radiat Oncol J"},{"key":"R7-20260127","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/S1079-2104(98)90373-0","article-title":"Initial presentation of hepatocellular carcinoma as a mandibular mass: Case report and review of the literature","volume":"86","author":"Chin","year":"1998","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod"},{"key":"R8-20260127","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.1016\/j.joen.2010.05.009","article-title":"Metastasis of hepatocellular carcinoma into the mandible with radiographic findings mimicking a radicular cyst: A case report","volume":"36","author":"Fujihara","year":"2010","journal-title":"J Endod"},{"key":"R9-20260127","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.oraloncology.2010.07.007","article-title":"Oral metastatic hepatocellular carcinoma: A changing demographic in Europe and North America. 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