ABSTRACT
INTRODUCTION AND IMPORTANCE: The most prevalent oral ulcers are those caused by trauma, and their etiopathogenesis has been frequently obvious. Yet, oral ulcers can be misdiagnosed and managed incorrectly. CASE PRESENTATION: A 25-year-old patient presented to our service with a painful lesion on the right lateral border of the tongue that had evolved for one week. A possible traumatic factor was identified. The ulcer completely recovered once the trauma's cause was removed. An accurate diagnosis was achieved by combining a precise physical examination with clinical follow-up. CLINICAL DISCUSSION: Single oral ulcers have various clinical presentations that can be confusing. Some of them may mimic oral squamous cell carcinoma (OSCC), especially when accompanied by any induration. Determining the cause of oral ulceration requires a careful medical history and a clinical examination with inspection and palpation, which may be combined with other accessory investigations if necessary. CONCLUSION: This clinical case reinforces the importance of investigating local causes before moving on to systemic ones. We present differential diagnosis and management algorithm of single oral ulcers.
ABSTRACT
INTRODUCTION AND IMPORTANCE: Numb chin syndrome (NCS), although rare, is an important clinical finding. It may be a metastatic neurologic manifestation of malignancy, often with no clinically visible pathologic finding. CASE PRESENTATION: A 40-year-old female, with prior history of breast cancer, presented to our service with complaint of pain and left mandibular hypoesthesia for four months. Panoramic showed several irregular osteolytic lesions of the mandibular body. CT-scan images showed a large irregular hypodense lesion and a tissue infiltration of the left mandibular body blowing the buccal cortex. Histopathology showed a neoplastic proliferation of carcinomatous cells positive for the cytokeratin AE1/AE3. A diagnosis of breast carcinoma mandibular metastasis was made. The patient was referred sent to the oncology committee. She was treated with Palbociclib and hormone therapy. CLINICAL DISCUSSION: In the oral cavity, the mandible is the most common site for metastasis. Metastatic tumors of the oral cavity may be asymptomatic or present different non-pathognomonic. Numb chin syndrome which is considered as an important presentation of oral metastases. The consideration of malignancy as a differential diagnosis may help in early diagnosis and intervention that may affect disease prognosis. CONCLUSION: Dentists and other oral health care providers must be aware of this condition to consider metastatic cancer in patients with unexplained facial hypoesthesia.
