RESUMO
BACKGROUND: Metastases in the mandibular condyle are rare. A survey of the literature showed that only 23 of 69 selected cases qualified under the criteria of Meyer and Shklar. REPORT OF A CASE: A 48-year-old white male suffering from a previously operated lung carcinoma was referred due to pain and discomfort in the left TMJ. A solitary condylar metastasis of the mandible was revealed. Because of diffuse tumorous infiltration into periarticular tissue, irradiation treatment was performed. During the long-term follow-up growth of additional skeletal metastases occurred. DISCUSSION: The course of condylar metastases in general is similar to other metastases involving the jaw. Breast cancer as the primary tumor is most frequent, followed by lung cancer. There are no specific clinical or radiological parameters leading to diagnosis. The clinician should take a potential metastasis into account when dealing with TMJ complaints, radiological oddities, and medical history of malignant tumors. For proper treatment planning, diagnosis should be based on histology. Since the diagnosis of metastasis is usually made at an advanced stage of disease, therapy will be mainly intended as palliative.
Assuntos
Carcinoma de Células Grandes/secundário , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Mandibulares/secundário , Medula Óssea/patologia , Carcinoma de Células Grandes/diagnóstico por imagem , Carcinoma de Células Grandes/patologia , Carcinoma de Células Grandes/cirurgia , Humanos , Neoplasias Pulmonares/patologia , Masculino , Côndilo Mandibular/diagnóstico por imagem , Côndilo Mandibular/patologia , Neoplasias Mandibulares/diagnóstico por imagem , Neoplasias Mandibulares/patologia , Pessoa de Meia-Idade , Invasividade Neoplásica , Estadiamento de Neoplasias , Radiografia Panorâmica , Tomografia Computadorizada por Raios XRESUMO
CASE REPORT: We report on a rare case of secondary chronic osteomyelitis of the left condyle. Haemophilus aphrophilus could be isolated from the abscess material. The condyle was resected and reconstructed with an endoprosthesis in the same operation. DISCUSSION: Possible causes of the rare location of secondary chronic osteomyelitis are assembled in a review of the literature and compared with the actual case. CONCLUSION: We suggest the inoculation of microorganisms through the needle of a local anesthetic injection, bacterial contamination during the tooth extraction, or bacteremia following the dental extraction to be possible causes for the infection.