Oral cavity metastases are rare, representing approximately 1% of all oral malignancies [1], and are difficult to diagnose because of their rarity and their atypical clinical and radiographic appearance. It isimportant to determine the diagnosis of an unhealed extraction socket. There are many considerations, especially in a patient with a prior diagnosis of cancer. A patient who has previously been diagnosedwith a bone metastasis is at risk for osteonecrosis, osteomyelitis, or bony metastasis. Furthermore, bothbisphosphonate related osteonecrosis of the jaw and osteoradionecrosis need to be considered in the differential diagnosis for a patient taking a bisphosphonate for cancer or osteoporosis, or who has previouslyreceived radiation therapy. Herein, we present a case of metastasis to an extraction socket in the mandible that lead to a definitivediagnosis of breast cancer metastasis. We also discuss the clinical detection of oral metastasis, the prognosis of which is very poor and therefore needs to be identified at an early stage. The oral cavity is aneasily accessible region, which can be directly evaluated, prompting further investigation for a metastaticlesion if required. (C) 2013 Asian AOMS, ASOMP, JSOP, JSOMS, JSOM, and JAMI. Published by Elsevier Ltd. All rightsreserved.