Pure mental neuropathy, also known as numb chin syndrome, can have various causes, but it is most commonly associated with underlying systemic conditions such as malignancies, especially metastatic tumors to the mandible or other parts of the jaw. Therefore, a patient presenting with pure mental neuropathy is most likely to have an underlying malignancy, particularly metastatic cancer affecting the mandible or nearby structures. However, it's essential for a healthcare professional to conduct a thorough evaluation and diagnostic workup to determine the specific cause in each individual case.