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We present the case of a 32-year-old male patient complaining of recurrent mandibular pain for 3.5 years. Panoramic radiography indicated increased cortical density of the mandibular lower border. Scintigraphy and single-photon emission computed tomography revealed metabolic hyperactivity in that region without pathologic lymph nodes. A bone biopsy specimen of the mandibular lower border did not have inflammation or cytologic atypia. Endocrinologic investigation confirmed secondary hyperparathyroidism as a result of hypovitaminosis D. Several weeks after starting therapy with oral vitamin D supplements, the symptoms completely disappeared. Increased cortical density is a rare manifestation of secondary hyperparathyroidism, which normally causes the lamina dura to vanish and produces a ground-glass appearance as a result of blurring of the trabecular bone pattern. Because focal hyperostosis can have multiple benign or malignant causes, radiologic examination of the jaw bones is indispensable for evaluating orofacial pain. Increased cortical density may be caused by metabolic diseases, requiring further investigations, including biopsy and blood analysis., (Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: Metastasis to the oral cavity can be located in both the soft and bony tissues and comprise only 1% of all oral malignancies; however, it is clinically significant because it indicates widespread metastatic disease and an unfavorable prognosis. A numb chin is an important presentation of oral metastasis, but other dental and systemic pathology may be involved., Presentation of Case: We present the case of a 54-year-old woman who presented with numb chin syndrome 8 years after a diagnosis of primary breast carcinoma. The former was caused by mandibular ramal metastasis of the tumor, which also spread to the spinal canal, ribs, pelvic bones, sacrum, and proximal femur. Because of widespread metastasis, palliative treatment was administered., Discussion: Despite its low incidence, oral metastasis should be considered as a diagnostic option when patients present with numb chin syndrome. Bony metastasis may produce symptoms late, in contrast to soft tissue metastasis. Pain is the first presenting symptom in most cases, but paresthesia, hypoesthesia and anesthesia in the facial region are possible symptoms too. Most oral bony metastasis are located in the mandible, especially in the molar region. Despite treatment, the average survival after diagnosis of mandibular metastasis is 6-7 months., Conclusion: In most cases with oral metastasis, palliative treatment is indicated. Early detection of oral lesions could improve treatment outcome and survival. A full diagnostic work-up is therefore of great importance., (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)