Primary intraosseous adenocarcinoma of the mandible: a rare case report

Primary intraosseous adenocarcinoma of the mandible: a rare case reportAbstractBackground: Primary intraosseous adenocarcinoma of the mandible is an exceptionally rare malignancy and represents a significant diagnostic challenge because it may mimic odontogenic lesions or metastatic disease.Case presentation: A 44-year-old woman presented with jaw pain and trismus lasting one month. Radiological imaging revealed a radiolucent lesion in the right mandibular angle. Initial biopsy suggested an odontogenic tumor; however, definitive histopathological and immunohistochemical analyses confirmed a well-differentiated adenocarcinoma of salivary gland type. Extensive diagnostic work-up excluded other primary malignancies. The patient underwent segmental mandibulectomy with selective neck dissection and reconstruction using a fibular free flap. No recurrence was observed during four years of follow-up.Conclusion: Accurate diagnosis of primary intraosseous adenocarcinoma requires careful clinical, radiological, and histopathological correlation to exclude metastatic and salivary gland malignancies. Surgical resection with adequate margins remains the cornerstone of treatment.Keywords: adenocarcinoma; mandible; intraosseous tumor; salivary gland carcinoma; case report