Burkitt's lymphoma presenting as lower lip paraesthesia in a 24 year old Nigerian. Case report

Abstract

An unusal case of stage D Burkitt's lymphoma in a 24 year old Nigerian female undergraduate is reported. There was a four month history of left lower lip paraesthesia followed three months later by a slowly progressive ‘pimple‐sized’ nodular mandibular swelling arising from the mental foramen region. A full‐blown, rapidly developing abdominal mass manifested only three weeks after a biopsy of the mandibular swelling. Aspiration of the latter and a histologic report of the mandibular mass confirmed Burkitt's lymphoma. The patient responded very well to appropriate chemotherapy. Clinicians should not overlook insidious jaw swellings in any adult residing in the endemic zone of Burkitt's lymphoma, in view of the fact that successful therapy is dependent on early diagnosis. Mental nerve paraesthesia is very rarely seen in Burkitt's lymphoma.

Maxillary sporadic Burkitt′s lymphoma associated with neuro-orbital involvement in an Indian male

“…Two reports of mental nerve neuropathy or “Numb chin syndrome” as only presentation of BL have been documented. [519] Our case showed unusual presentation; despite the aggressive maxillary tumor extending to orbit did not show any common presenting signs and symptoms such as tooth mobility, tooth displacement, pain, and sensory disturbances except facial swelling. Intraoral radiography showing break in the lamina dura around the teeth is one of the earliest radiological changes followed by numerous ill-defined small foci of radiolucent areas, which coalesce to form large radiolucent areas.…”

“…[151415] The differential diagnosis of acute swelling in the maxilla as initial and solo presentation without local factors is extremely difficult. It is very important for the oral medicine specialist to be familiar with such clinically presented rarities in the maxilla such as Langerhan's disease, eosinophilic granuloma, osteosarcoma, rhabdomyosarcoma, multiple myeloma, leukemia's, malignant lymphomas or other rarest conditions possible because of the fact that they are the first one to come across and early diagnosis and prompt referral is imperative to prevent dissemination and to obtain favorable prognosis.…”

“…[45161718] Clinical features of sBL may vary from no signs and symptoms to life-threatening airway obstruction according to the severity, anatomic location, and temporal presentation of the disease. [1] The clinical features in the jaws and surrounding structures may include facial swelling, exophytic growth, gingival hyperplasia, teeth mobility, teeth displacement, premature tooth eruption, pain, and/or sensory disturbances.…”

“…[4] Central nervous system (CNS) involvement in endemic BL is reported in one-third of the cases and may lead to headaches, paraplegia, and cranial nerve defects. [5] Endemic BL shows good response to treatment. [6]…”

Paraesthesia of the lip and chin area resolved by endodontic treatment: A case report and review of literature

“…26 Numbness has also been shown to develop following general anaesthesia. 27 Following endodontic treatment altered sensation may be due to the effects of filling material containing neurotoxic substances, such as paraformaldehyde, directly affecting the nerve.…”