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diagnosis. At present, in addition to ultrastructural studies,
immunohistochemical techniques are the most sensitive
methods available for the diagnosis of neuroendocrine
tumors. Treatment modalities for neuroendocrine
[9]
carcinomas of the oral cavity have included surgery,
multidrug chemotherapy, and radiotherapy, alone or
in combination. Currently, well-established treatment
protocols do not exist. Surgery alone is inadequate because
these tumors tend to progress rapidly and at the time of
diagnosis, they are reported to have a metastasis rate of
roughly 14-50%. [10]

The presentation of a malignant lesion in the orofacial
region may be the first indication of the existence of
an unknown malignancy at a distant primary site. The
Figure 5: Photomicrograph revealing nuclei with stippled chromatin presence of altered sensation in the area of the lower jaw
(H and E, ×40)
and lip/chin region in a patient with a known non-head and
DISCUSSION neck malignancy should alert the clinician to the possibility
of metastatic malignant disease. Appropriate investigations
Primary carcinomas which are reported to metastasize should be carried out to rule out other secondary and
to the jaws include those of the breast, lung, liver, colon manage the case satisfactorily.
and prostate. The primary carcinomas having highest
[1]
tendency to metastasize are different for both genders. Financial support and sponsorship
They are as follows in decreasing order: for women, breast Nil.
followed by carcinomas of the adrenal, colorectum, female
genital organs and thyroid; for men, the lung followed by Conflicts of interest
the prostate, kidney, bone and adrenals. [4] There are no conflicts of interest.

It has been reported that most metastatic oral tumors are REFERENCES
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Neuroendocrine (carcinoid) tumor of the mandible: a case report and
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Features that might assist in the assessment of malignancy Endod 1996;81:74-8.
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differentiation, functional activity and size of the tumor. tumor presenting in the mandible. Head Neck 1991;13:234-8.
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of the tumor into the bone and involvement of the inferior the jaws: a report of eight new cases. Med Oral Patol Oral Cir
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[7]
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should be considered to be due to mandibular metastases carcinoma of gingiva mimicking pyogenic granuloma. J Am Acad
until proven otherwise when seen in a patient with known Dermatol 2003;49:342-3.
malignancy. [8] 9. Yoshida H, Onizawa K, Hirohata H. Neuroendocrine carcinoma of
the tongue: report of a case. J Oral Maxillofac Surg 1995;53:823-7.
10. Devita VT, Hellman S, Rosenberg S. Cancer: Principles and Practice
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