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Int J Surg Case Rep. 2017;31:68-71. doi: 10.1016/j.ijscr.2017.01.001. Epub 2017 Jan 04.

Numb chin syndrome as a sign of mandibular metastasis: A case report.

International journal of surgery case reports

Thomas Aerden, Koenraad Grisar, Patrick Neven, Esther Hauben, Constantinus Politis

Affiliations

  1. Maxillofacial Surgery Department, University Hospitals Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium. Electronic address: [email protected].
  2. Maxillofacial Surgery Department, University Hospitals Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium.
  3. Multidisciplinary Breast Center, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.
  4. Department of Pathology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.
  5. OMFS-IMPATH Research Group, Dept. Imaging & Pathology, Faculty of Medicine, University Leuven and Head of the Maxillofacial Surgery Department, University Hospitals Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium.

PMID: 28110186 PMCID: PMC5256673 DOI: 10.1016/j.ijscr.2017.01.001

Abstract

INTRODUCTION: Metastasis to the oral cavity can be located in both the soft and bony tissues and comprise only 1% of all oral malignancies; however, it is clinically significant because it indicates widespread metastatic disease and an unfavorable prognosis. A numb chin is an important presentation of oral metastasis, but other dental and systemic pathology may be involved.

PRESENTATION OF CASE: We present the case of a 54-year-old woman who presented with numb chin syndrome 8 years after a diagnosis of primary breast carcinoma. The former was caused by mandibular ramal metastasis of the tumor, which also spread to the spinal canal, ribs, pelvic bones, sacrum, and proximal femur. Because of widespread metastasis, palliative treatment was administered.

DISCUSSION: Despite its low incidence, oral metastasis should be considered as a diagnostic option when patients present with numb chin syndrome. Bony metastasis may produce symptoms late, in contrast to soft tissue metastasis. Pain is the first presenting symptom in most cases, but paresthesia, hypoesthesia and anesthesia in the facial region are possible symptoms too. Most oral bony metastasis are located in the mandible, especially in the molar region. Despite treatment, the average survival after diagnosis of mandibular metastasis is 6-7 months.

CONCLUSION: In most cases with oral metastasis, palliative treatment is indicated. Early detection of oral lesions could improve treatment outcome and survival. A full diagnostic work-up is therefore of great importance.

Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Keywords: Case report; Mandibular metastasis; Numb chin

References

  1. J Oral Maxillofac Pathol. 2015 May-Aug;19(2):239-41 - PubMed
  2. Med Oral Patol Oral Cir Bucal. 2008 Oct 01;13(10):E616-21 - PubMed
  3. Neurology. 1992 Jun;42(6):1181-4 - PubMed
  4. Clin Epidemiol. 2012;4:87-93 - PubMed
  5. Oral Oncol. 2008 Aug;44(8):743-52 - PubMed
  6. BMJ Case Rep. 2011;2011:bcr0120113712corr1 - PubMed
  7. J Oral Maxillofac Pathol. 2013 Jan;17(1):71-5 - PubMed
  8. J Bone Miner Res. 2003 Feb;18(2):190-4 - PubMed
  9. Niger J Med. 2009 Apr-Jun;18(2):139-42 - PubMed
  10. Int J Surg. 2016 Oct;34:180-186 - PubMed
  11. J Oral Pathol. 1987 Aug;16(7):362-7 - PubMed
  12. Br J Oral Maxillofac Surg. 2003 Feb;41(1):3-6 - PubMed
  13. Oral Surg Oral Med Oral Pathol. 1965 Sep;20:350-62 - PubMed
  14. Head Neck Pathol. 2014 Dec;8(4):463-74 - PubMed

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