Sasaki Masashi, Yamazaki Hiroshi, Aoki Takayuki, Ota Yoshihide, Sekiya Ryo, Kaneko Akihiro
Department of Oral and Maxillofacial Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Mar;111(3):e11-6. doi: 10.1016/j.tripleo.2010.09.066. Epub 2011 Jan 7.
Numb chin syndrome (NCS), also known as mental nerve neuropathy, is characterized by facial and oral numbness restricted to the distribution of the mental nerve. Although not a common neuropathy, the clinical importance of this syndrome is its frequent association with malignancies, particularly breast cancer and lymphoma. In this paper, we present a rare case of Burkitt cell acute lymphocytic leukemia initially presenting with bilateral NCS. In this case, no abnormalities were detected on initial blood tests and radiologic investigations except for partial loss of lamina dura around mandibular teeth. Furthermore, we found no evidence of any other signs of central nervous system involvement apart from NCS. Nevertheless, the patient continued to experience severe bilateral mandibular pain and paresthesia, prompting us to repeat the blood studies. These showed lymphomatous cells, yielding the diagnosis of leukemia 37 days after the original presentation. When a patient presents with the extremely unusual symptoms of bilateral numbness of lower lip and chin, we should suspect the presence of a malignancy even in the absence of any relevant past history. If the initial radiologic investigations and blood tests reveal no abnormalities, malignancy should not be removed from the differential diagnosis until a definite cause has been found.
麻木性颏部综合征（NCS），也称为颏神经神经病，其特征为面部和口腔麻木，局限于颏神经的分布区域。虽然这不是一种常见的神经病，但该综合征的临床重要性在于它常与恶性肿瘤相关，尤其是乳腺癌和淋巴瘤。在本文中，我们报告了一例罕见的伯基特细胞急性淋巴细胞白血病，最初表现为双侧NCS。在该病例中，除下颌牙齿周围的硬骨板部分缺失外，初始血液检查和影像学检查未发现异常。此外，除NCS外，我们未发现任何其他中枢神经系统受累迹象的证据。然而，患者持续经历严重的双侧下颌疼痛和感觉异常，促使我们再次进行血液检查。检查发现了淋巴瘤细胞，在最初出现症状37天后确诊为白血病。当患者出现下唇和颏部双侧麻木这种极其不寻常的症状时，即使没有任何相关既往病史，我们也应怀疑存在恶性肿瘤。如果初始影像学检查和血液检查未发现异常，在找到明确病因之前，不应排除恶性肿瘤的鉴别诊断。
