Periosteal reaction in a metastatic prostate adenocarcinoma involving the mandible: case report and literature review

Introduction

A 65-year-old male presented with a 6-month history of right facial swelling and paresthesia of the lower jaw. CBCT revealed an expansile, ill-defined, mixed radiolucent-radiopaque lesion with lingual cortical bony expansion and spiculated appearance. Although not pathognomonic, the spiculated periosteal reaction is most commonly reported with primary bone tumors such as osteosarcoma.

Materials and Methods

Case report and literature review

Results

An incisional biopsy was performed, revealing sheets and irregular islands of pleomorphic malignant blue cells infiltrating bony trabeculae. Immunohistochemical staining was performed. Based on the histologic and immunohistochemical findings, a diagnosis of high-grade prostate adenocarcinoma was rendered.

Utilizing PubMed, Ovid, Scopus, and Google Scholar Databases, the authors conducted a search of all full-text case reports, case series, and literature reviews in the English language published from 2000-2020 and report on the incidence of a “sunburst” and "spiculated" periosteal reaction in association with metastatic prostate adenocarcinoma to the mandible.

Conclusions

Metastatic prostate adenocarcinoma to the mandible can produce a spiculated periosteal proliferation of bone resembling that of a primary bone tumor.