# Mandibular Metastasis From Colon Cancer Presenting as Jaw Pain

## TL;DR

A rare case of colon cancer spreading to the jaw is reported, highlighting the importance of early diagnosis and treatment for better outcomes.

## Contribution

This case report highlights mandibular metastasis from colon cancer as a rare and severe clinical presentation.

## Key findings

- Mandibular metastasis from colorectal cancer is exceedingly rare and often presents with isolated jaw pain.
- Systemic chemotherapy with FOLFOX and bevacizumab showed early clinical and biochemical response in this patient.
- Oral metastasis from CRC is associated with poor prognosis, emphasizing the need for timely diagnosis and treatment.

## Abstract

Colorectal cancer (CRC) may rarely present with atypical symptoms, particularly in the context of metastatic disease. While the most common sites of metastasis include the liver, lungs, peritoneum, and lymph nodes, osseous metastases are uncommon, and mandibular involvement is exceedingly rare. We report a case of a 57-year-old male who presented with several weeks of isolated jaw pain. Imaging revealed a destructive mass in the right mandible, and histopathology confirmed metastatic adenocarcinoma of colorectal origin. Abdominal imaging and colonoscopy identified a fungating, partially obstructing sigmoid mass with synchronous liver metastases. Due to extensive disease, surgical resection was not pursued. The patient was initiated on systemic chemotherapy with folinic acid, 5-fluorouracil, and oxaliplatin (FOLFOX) and bevacizumab, with early biochemical and clinical response. This case demonstrates that oral metastasis of CRC portends a poor prognosis. Therefore, high clinical suspicion, timely diagnosis, and initiation of systemic therapy are essential to optimize patient outcomes and maintain quality of life.