PMC5256673_01
Numbness of the right chin region.
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The numbness did not involve the lower lip (Fig. 1).
PET-CT shows high metabolic activity in the right ramal region.
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The orthopantomogram (OPG) showed no significant abnormalities, so it was supplemented with a CBCT and a PET-CT (Fig. 2).
Skeletal scintigraphy indicates a metabolic active lesion, consistent with ramal mandibular metastasis.
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Supplementary skeletal scintigraphy indicated diffuse bony metastasis in the spinal canal, ribs, pelvic bones, sacrum, proximal femur, and right mandibular ramus (Fig. 3).
(a) The epithelioid cells in the marrow spaces are strongly positive for GATA3, a marker of breast carcinoma (magnification 200x). (b) The epithelioid cells in the marrow space were also positive for the estrogen receptor (magnification 200x).
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The anatomopathologic investigation of the biopsy indicated the presence of breast metastasis, which were estrogen and progesterone receptor-positive and HER-2 receptor-negative (Fig. 4a and b).