Suga Takayuki, Takenoshita Miho, Tu Trang T H, Sugawara Takashi, Kirimura Susumu, Toyofuku Akira
Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, 113-8510, Tokyo, Japan.
Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Biopsychosoc Med. 2021 Mar 21;15(1):7. doi: 10.1186/s13030-021-00209-y.
An oral burning sensation with unidentified cause in patients with preexisting psychosocial conditions is usually diagnosed as burning mouth syndrome. However, unexpected organic lesions may be detected in rare cases.
A 35-year-old woman had chief complaints of a burning sensation and numbness of the right side of the lip and tongue, as well as a dry sensation of the mouth with a taste disturbance of the right side of the tongue. The symptoms were continuous and did not show any daily fluctuations. The symptoms started without any recognizable triggering factor six months before her first visit to our clinic,. No abnormality was detected in her mouth. MRI images revealed an approximately 30 × 30 mm well-defined mass localized in the right cerebropontine angle compressing the trigeminal nerve, which was diagnosed as schwannoma of the right auditory nerve.
It is important for clinicians to consider the possibility of brain tumors in their differential diagnosis of BMS. Although it is not always easy to eliminate all diseases that may cause an oral burning sensation in patients with BMS-like symptoms, more attention and careful examination based on the patient's psychosomatic background features and other possible causes are needed to rule out organic diseases.
在已有心理社会状况的患者中,原因不明的口腔烧灼感通常被诊断为灼口综合征。然而,在罕见情况下可能会发现意外的器质性病变。
一名35岁女性的主要症状为右侧嘴唇和舌头有烧灼感和麻木感,以及口腔干燥伴右侧舌味觉障碍。症状持续存在,无任何每日波动。在她首次就诊于我们诊所前六个月,症状无任何可识别的触发因素就开始了。口腔检查未发现异常。磁共振成像(MRI)图像显示,在右侧脑桥小脑角有一个边界清晰、大小约为30×30 mm的肿块,压迫三叉神经,诊断为右侧听神经鞘瘤。
临床医生在灼口综合征的鉴别诊断中考虑脑肿瘤的可能性很重要。虽然要消除所有可能导致具有灼口综合征样症状患者出现口腔烧灼感的疾病并非总是容易,但需要更多关注并根据患者的心身背景特征和其他可能原因进行仔细检查,以排除器质性疾病。