{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:19:34Z","timestamp":1787847574539,"version":"build-2784847793"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>Oral metastasis, although rare, tends to involve jawbones, particularly the posterior region of the mandible, and involvement of oral soft tissues, even when less likely, is most often seen on the gingiva and tongue. Clinically, the soft-tissue masses tend to mimic pyogenic granuloma, peripheral giant cell granuloma or an epulis and thus are difficult to diagnose and identify. The jaw bone is preferred by prostate carcinoma as a metastatic target. Prostate malignancy, which is more common in Western countries than in India, may be adenocarcinomas or carcinomas. Oftentimes, metastatic lesions develop in the alveolar region and are a cause for tooth mobility, yet, they tend to be detected only after extraction of the affected tooth. In such cases, the symptomatic presentation therefore, is vague and indicative of tooth mobility secondary to periodontal pathology unless, a detailed history and follow-up is done. We report a case of a male patient who presented to our department with a proliferative, painful, swelling postextraction of the left first molar region, and the lesion was seen at the extraction site as well as in the mandibular anterior tooth region. The swelling was associated with palpable lymph nodes. Orthopantomogram showed an irregular, radiolucent lesion extending from the lower left central incisor to the left first molar region in the mandibular alveolus. Incisional biopsy tissue came with provisional diagnosis of osteomyelitis or squamous cell carcinoma as the patient was a habitual bidi smoker for more than 20 years. Histologically, it was an undifferentiated tumor with tumor cells seen in deep connective tissue with a lack of lineage differentiation. An undifferentiated malignant tumor represents either a metastasis of unknown origin or a primary neoplasia without obvious cell line of differentiation. Immunohistochemistry (IHC) of undifferentiated tumors helps to categorize them into small round blue cell tumors or large cell tumors. The oral pathologist was perplexed as there was no mention of any other malignancy in the patient's history, which, however, was noted by the surgeons few days later. Hence, initially, a hematopoietic malignancy was suspected which was ruled out by IHC, and later, staining with cytokeratin 7 (CK7), CK-high molecular weight and P63 confirmed prostate metastases as all three were negative.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jomfp.jomfp_342_20","type":"journal-article","created":{"date-parts":[[2021,6,28]],"date-time":"2021-06-28T11:15:20Z","timestamp":1624878920000},"page":"203","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Metastasis in the mandible involving gingiva"],"prefix":"10.4103","volume":"25","author":[{"given":"Sonalee J","family":"Shah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biswajit","family":"Mishra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Jadwani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-46-20240906","doi-asserted-by":"crossref","first-page":"344","DOI":"10.4103\/ijdr.IJDR_261_16","article-title":"Oral gingival metastasis: A diagnostic dilemma","volume":"28","author":"Aswath","year":"2017","journal-title":"Indian J Dent Res"},{"key":"R2-46-20240906","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1186\/1477-7819-12-401","article-title":"Metastasis of prostate carcinoma in the mandible manifesting as numb chin syndrome","volume":"12","author":"Aksoy","year":"2014","journal-title":"World J Surg Oncol"},{"key":"R3-46-20240906","doi-asserted-by":"crossref","first-page":"122","DOI":"10.4103\/jiaomr.JIAOMR_252_15","article-title":"A rare presentation of prostate adenocarcinoma metastatic to the maxilla","volume":"29","author":"Prathi","year":"2017","journal-title":"J Indian Acad Oral Med Radiol"},{"key":"R4-46-20240906","first-page":"e5093","article-title":"Metastatic tumour to the mandible \u2013 A diagnostic and management dilemma","volume":"11","author":"George","year":"2019","journal-title":"Cureus"},{"key":"R5-46-20240906","first-page":"66","article-title":"Pathophysiology of bone metastasis & its implications \u2013 A review","volume":"4","author":"Shah","year":"2012","journal-title":"Ann Essences Dent"},{"key":"R6-46-20240906","first-page":"E424","article-title":"Prostatic adenocarcinoma with mandibular metastatic lesion: Case report","volume":"12","author":"Reyes Court","year":"2007","journal-title":"Med Oral Patol Oral Cir Bucal"},{"key":"R7-46-20240906","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1111\/j.1600-0714.1993.tb00128.x","article-title":"Metastases to the oral mucosa: Analysis of 157 cases","volume":"22","author":"Hirshberg","year":"1993","journal-title":"J Oral Pathol Med"},{"key":"R8-46-20240906","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1016\/j.oraloncology.2007.09.012","article-title":"Metastatic tumours to the oral cavity \u2013 Pathogenesis and analysis of 673 cases","volume":"44","author":"Hirshberg","year":"2008","journal-title":"Oral Oncol"},{"key":"R9-46-20240906","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/S0266-4356(02)00301-7","article-title":"Oral metastases: Report of 24 cases","volume":"41","author":"van der Waal","year":"2003","journal-title":"Br J Oral Maxillofac Surg"},{"key":"R10-46-20240906","doi-asserted-by":"crossref","first-page":"18","DOI":"10.4103\/jomr.jomr_3_19","article-title":"Prostatic adenocarcinoma with mandibular metastasis","volume":"7","author":"Saxena","year":"2009","journal-title":"J Oral Maxillofac Radiol"},{"key":"R11-46-20240906","first-page":"b67","article-title":"Metastases to the mouth and jaws: A contemporary Canadian experience","volume":"77","author":"Daley","year":"2011","journal-title":"J Can Dent Assoc"},{"key":"R12-46-20240906","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1590\/1679-775720130148","article-title":"Mandibular metastasis of adenocarcinoma from prostate cancer: Case report according to epidemiology and current therapeutical trends of the advanced prostate cancer","volume":"21","author":"Menezes","year":"2013","journal-title":"J Appl Oral Sci"},{"key":"R13-46-20240906","doi-asserted-by":"crossref","first-page":"208","DOI":"10.3389\/fimmu.2019.00208","article-title":"Oral mucosal epithelial cells","volume":"10","author":"Groeger","year":"2019","journal-title":"Front Immunol"},{"key":"R14-46-20240906","doi-asserted-by":"crossref","first-page":"326","DOI":"10.5858\/2008-132-326-UTTIBI","article-title":"Undifferentiated tumor: True identity by immunohistochemistry","volume":"132","author":"Bahrami","year":"2008","journal-title":"Arch Pathol Lab Med"},{"key":"R16-46-20240906","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1056\/NEJM199003013220907","article-title":"The cellular basis of site-specific tumor metastasis","volume":"322","author":"Flier","year":"1990","journal-title":"N Engl J Med"}],"container-title":["Journal of Oral and Maxillofacial Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jomfp.jomfp_342_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:22:38Z","timestamp":1787844158000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jomfp.jomfp_342_20"}},"subtitle":["An intriguing case with a perplexing pathology"],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/jomfp.jomfp_342_20","relation":{},"ISSN":["0973-029X"],"issn-type":[{"value":"0973-029X","type":"print"}],"subject":[],"published":{"date-parts":[[2021,1]]}}}