Metastatic Tumors to Craniofacial Skeleton: Analysis of Two Cases and Review of the Literature

Craniofacial skeletal metastasis is a rare presentation of advanced prostate cancer. This is a report of a 69-year-old man who presented with numbness of the right lower lip and recently ill-fitting lower denture. Based on the medical history of benign prostate hyperplasia (BPH) and suspicion of a metastatic tumor, prostate core needle biopsy was performed. Histology of the prostate biopsy confirmed an adenocarcinoma with Gleason Score of 6/10. The diagnosis of metastatic prostate adenocarcinoma was established by incisional biopsy from the mandibular lesion. Androgen deprivation therapy (ADT) was administered along with bilateral orchidectomy and radiotherapy. He had a significant resolution of trigeminal nerve palsy and the other symptoms at subsequent follow-ups, but after 18 months passed away. The second case was a 65-year-old man with a history of prostate cancer since 5 years ago. He complained of painful swelling in the right side of the face. Radiographic evaluation revealed new bone formation in right mandibular ramus and condylar process as well as the left temporoparietal region. Incisional biopsy from mandibular lesion revealed metastatic prostate adenocarcinoma. Palliative radiotherapy for increasing quality of life started for the patient but he died after 9 months. The related literatures were reviewed.