A Rare Case of Misdiagnosed Silent Lung Cancer with Solitary Metastasis to the Temporomandibular Joint Condyle.

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A Rare Case of Misdiagnosed Silent Lung Cancer with Solitary Metastasis to the Temporomandibular Joint Condyle.

J Oral Facial Pain Headache. 2017 Spring;31(2):180-185

Authors: Guarda-Nardini L, Stellini E, Di Fiore A, Manfredini D

Abstract
This article describes the case history of a 59-year-old female patient who sought advice for temporomandibular joint (TMJ) pain and sounds but who was actually diagnosed with a primary lung cancer with metastasis to the TMJ. The patient had a history of TMJ pain and deflection in jaw movement that progressively worsened over a few months and did not improve with the usual standard of care treatment provided by an orofacial pain practitioner. Magnetic resonance and computed tomography (CT) prescribed at a tertiary clinic showed an osteolytic bone mass within the right TMJ condyle. The neoformation was surgically removed and histologic assessment revealed it was a metastasis of a silent lung carcinoma. Thorax CT confirmed the presence of a formation within the apical segment of the right lung superior lobe. While this scenario of a silent lung cancer metastasis to the TMJ condyle mimicking classical symptoms of temporomandibular disorders (TMD) is rare, it does indicate that the path to differential diagnosis is often difficult in TMD and orofacial pain patients, and that practitioners managing such patients should be aware of the variegate spectrum of possible TMD-mimicking conditions to avoid dangerous diagnostic delays.

PMID: 28437516 [PubMed - in process]

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