A case is described of a 57-year-old woman with jaw metastasis from rectal adenocarcinoma who underwent colectomy and ovariectomy for moderately differentiated adenocarcinoma of the large intestine and peritoneal carcinosis. This patient subsequently underwent several cycles of chemoantiblastic therapy although, approximately six months after the initial surgery, a tumefaction of the gingival mucosa was found in the lower right premolar area. Radiography showed this neoformation to be an area of mandibular osteolysis. A biopsy, performed at the E.N.T Clinic of the IRCCS Oncological Hospital in Bari, Italy, revealed a metastatic lesion from rectal adenocarcinoma. This led to radiation therapy vs. the external fascia of the mandibular lesion. Then, given that further cerebral and hepatic metastases were found, palliative treatment was administered until the patient's death in June 2000. A review of the international literature shows how unusual it is to find secondary metastases from rectal adenocarcinoma in the mandibular region (only 23 cases have been published in the last forty years). For nearly all the authors examined, the treatment of choice for such lesions was radiation therapy associated with chemoantiblastic therapy. Despite such treatment, the literature bears significant agreement as to the poor, short-term prognosis.
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