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Metastatic Hepatocellular Carcinoma Presenting in the Mandible

 Lovekesh Kumar

Hepatocellular carcinoma is a primary malignant tumor of the liver and the most common liver malignancy usually arising in the setting of liver cirrhosis. Metastatic spread of the tumor is through vascular channels mainly to the lung (58%) but lymphatic spread is also present with lymph node metastasis the second most common site (10-42%). Metastasis to bone has incidence ranging from 3% to 20%. Oral metastasis has been reported in literature to be <1% with a worse outcome. Here we present a case of metastatic hepatocellular carcinoma to the posterior mandible and mucosa in a 58 year old female presenting as an ulcerated mass after tooth extraction. The patient had no known co-morbid and had no clinical cervical lymphadenopathy. She was started on chemotherapy but succumbed to the disease a couple of weeks later. The case reveals possibility of other tumors presenting in the oral cavity as ulcerative lesions other than oral squamous cell carcinoma in high prevalence areas of oral squamous cell carcinoma.