Hakkou Fouzia, Ouaabbou Hajar, El Ouazzani Hafsa, Cherradi Nadia, Chbicheb Saliha
Department of Oral Surgery, Faculty of Dentistry, Mohammed V University, Morocco.
Department of Oral Surgery, Faculty of Dentistry, Mohammed V University, Morocco.
Int J Surg Case Rep. 2023 Jun;107:108175. doi: 10.1016/j.ijscr.2023.108175. Epub 2023 Apr 11.
Numb chin syndrome (NCS), although rare, is an important clinical finding. It may be a metastatic neurologic manifestation of malignancy, often with no clinically visible pathologic finding.
A 40-year-old female, with prior history of breast cancer, presented to our service with complaint of pain and left mandibular hypoesthesia for four months. Panoramic showed several irregular osteolytic lesions of the mandibular body. CT-scan images showed a large irregular hypodense lesion and a tissue infiltration of the left mandibular body blowing the buccal cortex. Histopathology showed a neoplastic proliferation of carcinomatous cells positive for the cytokeratin AE1/AE3. A diagnosis of breast carcinoma mandibular metastasis was made. The patient was referred sent to the oncology committee. She was treated with Palbociclib and hormone therapy.
In the oral cavity, the mandible is the most common site for metastasis. Metastatic tumors of the oral cavity may be asymptomatic or present different non-pathognomonic. Numb chin syndrome which is considered as an important presentation of oral metastases. The consideration of malignancy as a differential diagnosis may help in early diagnosis and intervention that may affect disease prognosis.
Dentists and other oral health care providers must be aware of this condition to consider metastatic cancer in patients with unexplained facial hypoesthesia.
麻木性下颌骨综合征(NCS)虽罕见,但却是一项重要的临床发现。它可能是恶性肿瘤的转移性神经表现,通常无临床可见的病理表现。
一名40岁女性,有乳腺癌病史,因疼痛和左下颌感觉减退4个月前来就诊。全景片显示下颌骨体有多个不规则溶骨性病变。CT扫描图像显示左下颌骨体有一个大的不规则低密度病变及组织浸润,突破颊侧皮质。组织病理学显示癌细胞呈细胞角蛋白AE1/AE3阳性的肿瘤性增殖。诊断为乳腺癌下颌骨转移。患者被转诊至肿瘤学委员会。她接受了哌柏西利和激素治疗。
在口腔中,下颌骨是最常见的转移部位。口腔转移性肿瘤可能无症状或表现出不同的非特异性症状。麻木性下颌骨综合征被认为是口腔转移的重要表现。将恶性肿瘤作为鉴别诊断考虑有助于早期诊断和干预,这可能会影响疾病预后。
牙医和其他口腔保健提供者必须了解这种情况,以便在有不明原因面部感觉减退的患者中考虑转移性癌症。