Mandibular metastatic hepatocellular carcinoma: Report of a case involvingsevere and uncontrollable hemorrhage

Hepatocellular carcinoma (HCC) is a malignant tumor with a marked tendency, to spread through the portal system. Metastases from HCC usually involve l ungs, surrenal glands, the skeletal and gastroenteric systems, spleen, hear t and kidneys. Secondary localizations to the mandible are rare. Generally, bone metastases from HCC appear as osteolytic lesions more likely localize d to the ribs, spine, femor, omer, sternum, and then to the mandible. Mandi bular metastatic HCC is hemorrhagic in nature because of its hypenascularit y. Any diagnostic maneuver that could end in bleeding should be avoided. No n-invasive diagnostic procedures such as computer tomography (CT) scan shou ld be preferred. Among the invasive diagnostic procedures, only fine needle biopsy should be attempted and palliative radiotherapy, could be useful fo r the control of local symptoms. A case report of a hemorrhagic mandibular metastatic HCC that had to be treated surgically, in order to control the s evere and profuse bleeding, is presented.