Dental pulp metastasis from oral squamous cell carcinoma: a case report and a review of the literature

A 61-year-old man was seen in the Oral Pathology Department with a three months history of right mandibular pain. Clinical examination revealed a 3 cm mass involving the body and the angle of the right site of the mandible and palpable masses in the neck. The dental panoramic radiography showed on the right a radiolucency area surrounding the lower second molar extending to the mandible angle. Additionally, chest radiograph and routine laboratory analysis results were unremarkable. An incisional biopsy of the area, revealed histologically a well differentiated squamous cell carcinoma and after few days, the patient was operated of right hemimandibulectomy with dissection of submandibular salivary gland and laterocervical lymphnodes on the same side. The histology of surgical material confirmed the diagnosis of a differentiated squamous cell carcinoma G1, omotateral diffusion in the mandible bone and metastasis to the dental pulp of the second lower molar tooth and to one of 18 lymphnodes dissected. In this report is described a very rare metastasis to the dental pulp and literature review, in which only fifteen other cases are reported.