METASTATIC THYROID CARCINOMA TO THE MANDIBLE MIMICKING A VASCULAR MALFORMATION: CASE REPORT

Metastasis to the oral cavity is uncommon, accounting for just 1% of all oral cavity malignancies. It is most commonly found in the jaw bones, especially the mandible. Thyroid cancers have been shown to account for up to 6% of oral cavity metastases, with follicular forms occurring more commonly. Since these tumours are hypervascular, a diagnosis of vascular malformation must be discussed, and vascular regulation must be ensured to prevent any hemorrhagic event. In this paper, we present an unusual case of thyroid carcinoma metastasis to the mandibular region in a 65-year-old female patient.Following assessment and confirmation, it was decided to resect the metastatic mandibular mass concurrently with a complete thyroidectomy. The left external carotid artery was ligated first to avoid further bleeding from the high-flow mandibular lesion. A follicular thyroid carcinoma of the thyroid gland with extracapsular extension and vascular invasion was discovered in the surgical specimen, as well as a metastatic follicular thyroid carcinoma to the mandible. Following surgery, the patient was given a 150 millicuries dose of radioactive Iodine-131. She is being followed up on on a daily basis and is now disease-free.To summarise, the clinical presentation of a metastatic lesion to the jaw bone, especially the mandible, may be daunting for a clinician, and for a secondary tumour from a thyroid primary, a consideration for metastatectomy should be made, given the potential for long-term symptom and disease management and probably a favourable long-term outcome.

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