Numb Chin Syndrome: Atypical presentation of metastatic breast cancer

Britta L. Bureau, Jennifer M. Connelly, P. Barkhaus, DO RyanBrennan
{"title":"Numb Chin Syndrome: Atypical presentation of metastatic breast cancer","authors":"Britta L. Bureau, Jennifer M. Connelly, P. Barkhaus, DO RyanBrennan","doi":"10.17161/rrnmf.v4i2.18725","DOIUrl":null,"url":null,"abstract":"Introduction/Background: Numb chin syndrome (NCS) is an uncommon but known complication of cancer. Prompt recognition is imperative to directed treatment. In some instances, numb chin may be complicated by other findings. \n  \nCase Report: A 53-year-old female with past medical history of estrogen receptor positive invasive ductal breast carcinoma underwent partial mastectomy, chemotherapy, and radiation. After 6 years remission, new lung and liver metastases occurred, and chemotherapy resumed.  Imaging was negative.  Eight weeks later, she developed left chin numbness followed by progressive difficulty retaining food and drink.  Her left lower lip weakened. \n  \nNeurological examination revealed left lower lip weakness (showing a “droop” with attempted smile).  The area of decreased sensation to sharp touch had expanded from the left chin to the nasolabial fold.  The remainder of her neurological examination was unremarkable. Contrast-enhanced MRI was repeated which revealed a 1.9 cm enhancing left parotid mass. \n  \nSummary/Conclusion: NCS is defined as an ipsilateral loss of chin sensation. If there is no history of trauma or dental injury and especially if the presentation is atypical, then cancer is the most likely etiology. This case began as an uncomplicated NCS that rapidly expanded to involve a greater portion of the trigeminal nerve distribution, in addition to a branch of the facial nerve.  Thus, each focal deficit was not the result of separate distal nerve lesions, but rather partial proximal cranial neuropathies at their parotid gland propinquity.","PeriodicalId":309700,"journal":{"name":"RRNMF Neuromuscular Journal","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"RRNMF Neuromuscular Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.17161/rrnmf.v4i2.18725","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction/Background: Numb chin syndrome (NCS) is an uncommon but known complication of cancer. Prompt recognition is imperative to directed treatment. In some instances, numb chin may be complicated by other findings.   Case Report: A 53-year-old female with past medical history of estrogen receptor positive invasive ductal breast carcinoma underwent partial mastectomy, chemotherapy, and radiation. After 6 years remission, new lung and liver metastases occurred, and chemotherapy resumed.  Imaging was negative.  Eight weeks later, she developed left chin numbness followed by progressive difficulty retaining food and drink.  Her left lower lip weakened.   Neurological examination revealed left lower lip weakness (showing a “droop” with attempted smile).  The area of decreased sensation to sharp touch had expanded from the left chin to the nasolabial fold.  The remainder of her neurological examination was unremarkable. Contrast-enhanced MRI was repeated which revealed a 1.9 cm enhancing left parotid mass.   Summary/Conclusion: NCS is defined as an ipsilateral loss of chin sensation. If there is no history of trauma or dental injury and especially if the presentation is atypical, then cancer is the most likely etiology. This case began as an uncomplicated NCS that rapidly expanded to involve a greater portion of the trigeminal nerve distribution, in addition to a branch of the facial nerve.  Thus, each focal deficit was not the result of separate distal nerve lesions, but rather partial proximal cranial neuropathies at their parotid gland propinquity.
麻木下巴综合征:转移性乳腺癌的不典型表现
简介/背景:麻木下巴综合征(NCS)是一种罕见但已知的癌症并发症。及时识别是指导治疗的必要条件。在某些情况下,麻木的下巴可能会因其他发现而复杂化。病例报告:一位53岁女性,既往有雌激素受体阳性浸润性导管乳腺癌病史,接受了乳房部分切除术、化疗和放疗。缓解6年后,出现新的肺和肝转移,重新开始化疗。显像阴性。8周后,患者出现左下巴麻木,并逐渐出现进食和饮水困难。她的左下唇变弱了。神经学检查显示左下唇无力(表现为试图微笑的“下垂”)。感觉下降到尖锐触觉的区域从左下巴扩展到鼻唇襞。其余的神经学检查结果一般。重复MRI造影显示左侧腮腺肿块1.9 cm增强。摘要/结论:NCS被定义为同侧下颌感觉丧失。如果没有外伤或牙齿损伤史,特别是如果表现不典型,那么癌症是最有可能的病因。本病例最初是一个简单的NCS,迅速扩展到三叉神经分布的大部分,除了面神经的一个分支。因此,每个局灶性缺损不是单独的远端神经病变的结果,而是部分近端脑神经病变在腮腺附近的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信