Numb chin syndrome

Perez, Cristina; Leeuw, Reny de; P., Francisco Escala; Fuentealba, Rodrigo A.; Klasser, Gary D.

doi:10.1016/j.adaj.2022.03.007

Cited by 3 publications

(3 citation statements)

References 91 publications

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“…Besides oral problems in cancer patients undergoing CT for solid tumors, a dedicated attention has been posed to the NCS, a rare sensitivity neuropathy that usually expresses itself with unilateral sensitivity alterations in lip and/or chin regions. It is mostly caused by bone metastases in the mandibular body, which represents less than 1% of all bone metastases [ 46 ] and its onset seems to be a negative prognostic factor for patient’s survival [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Oral Problems in Oncology Patients Undergoing Chemotherapy for Solid Tumors: A Prospective Observational Study

Ottaviani,

Targato,

Rupel

et al. 2023

Cancers

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PURPOSE: Oral problems in a group of oncological patients undergoing chemotherapy (CT) for solid tumors have been examined. Incidence and severity of patients’ self-reported oral problems have been evaluated along their interaction with age, gender, tumor diagnosis and stage, presence of mestastasis, CT agent type, and number of CT cycle. We also analyzed the presence of paraesthesia and anaesthesia and their predisposing factors associated with clinical and treatment-related variables. METHODS: Patients were asked to fill in a questionnaire to evaluate the onset and the intensity of oral and perioral pain, oral mucositis, salivary gland hypofunction, dysgeusia, dysphagia, dysphonia, and sensitivity neuropathy (paraesthesia or dysaesthesia) since the last CT infusion. We also investigated which types of medications have possibly been used and who recommended it, as well as patients’ degree of awareness about the possibility of oral problems arising during CT. RESULTS: We recruited 194 patients and obtained 491 questionnaires. We found that a metastatic disease was a risk factor for OM (OR 2.02, p = 0.026) and salivary gland hypofunction (OR 1.66, p = 0.042) and that platinum agents, compared to mitotic inhibitors, increased the risk of developing salivary gland hypofunction (OR 2.16, p = 0.013), dysphagia (OR 3.26, p = 0.001), and anaesthesia (OR 5.16, p = 0.041). Young age was a slight protective factor for most symptoms. The 80% of enrolled patients were informed by the oncologist about possible oral problems arising during CT. CONCLUSIONS: Our study highlighted the importance of collecting observational data from the patients’ perspective on oral problems arising during the routine oncology practice, across a range of solid tumors and CT regimens. The relevance of these findings focused on the key role of the multidisciplinary team in advising the patients on the possible occurrence of oral problems, also by recommending their management.

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Section: Discussionmentioning

confidence: 99%

Oral Problems in Oncology Patients Undergoing Chemotherapy for Solid Tumors: A Prospective Observational Study

Ottaviani,

Targato,

Rupel

et al. 2023

Cancers

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“…Numb chin syndrome (NCS) is a rare, sensory neuropathy that affects the mental nerve, leading to unilateral or bilateral altered sensations, decreased sensitivity or absence of pain in the chin and surrounding regions. Perez et al (12) recently reported that NCS was associated with various local and systemic etiological factors (summarized in Table I), including primary mandibular tumors or distant metastases of other cancers . It is commonly observed in association with metastasized breast cancer (32%), lymphoma and leukemia (24%), or prostate cancer (9%), and less frequently observed in association with lung cancer, myeloma, bone cancer, soft-tissue cancer, colon cancer, kidney cancer, adenoid cystic carcinoma, melanoma, skin cancer and digestive cancers such as GBC (13)(14)(15)(16)(17)(18)(19).…”

Section: Metastatic Gallbladder Cancer Presenting As Numb Chin Syndro...mentioning

confidence: 99%

Metastatic gallbladder cancer presenting as numb chin syndrome: A case report and literature review

Murahashi,

Ntege,

Ide

et al. 2024

Biomed Rep

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Gallbladder cancer (GBC) is an uncommon malignancy that is highly aggressive in the advanced stages. However, it rarely metastasizes to the mandible. Numb chin syndrome (NCS) is a rare neurological manifestation associated with various underlying causes, including occult primary cancers and distant metastases. It is often considered to be a significant indicator of malignancy, and thorough investigation is essential in the presence of unclear etiology. The current study reported on the case of a 69-year-old Japanese woman who presented with numbness and mild pain in the lower lip and chin area for three months. No other systemic symptoms were observed. Immunocytochemical examination revealed the presence of an adenocarcinoma and TNM staging as per the Union for International Cancer Control and the American Joint Committee on Cancer guidelines confirmed stage IVb GBC. Comprehensive full-body positron emission tomography-computed tomography examination using 18 F-fluoro-2-deoxy-D-glucose revealed additional bone and soft-tissue metastases. Palliative chemotherapy and radiation treatment were initiated based on the advanced stage of disease at the time of diagnosis. However, the patient succumbed to multiple organ failure six months later. The simultaneous occurrence of GBC, mandibular metastasis and NCS is rare and associated with poor prognosis. Despite the widespread nature of the disease, it can often manifest as non-specific oral symptoms without any systemic indications. The current study emphasizes the critical importance of timely confirmatory testing for accurate diagnosis and initiation of appropriate management for such complex conditions.

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“…Numb chin syndrome (NCS) is a common cause of hypesthesia of the mandible and lower lip caused by damage to the inferior alveolar nerve or the mandibular nerve and is not limited to dental treatment or osteomyelitis. There have been scattered reports of mandibular metastases from hematologic diseases such as leukemia and malignant lymphoma, as well as prostate and breast cancer, in the case of solid tumors [1,2]. The number of patients with colorectal cancer has been increasing in recent years, and it is one of the most common cancers in the latest cancer statistics, with a high incidence reported in East Asia [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Numb Chin Syndrome as the Initial Presentation of Mandibular Metastasis of Colorectal Cancer: A Case Report

Goto,

Hijioka,

Uchino

et al. 2024

Cureus

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Numb chin syndrome (NCS) is hypesthesia of the mandible and lower lip caused by damage to the inferior alveolar or mandibular nerves, commonly due to dental treatment or osteomyelitis, but occasionally caused by malignant tumors. We report the case of a male in his 60s. He came to our hospital with a chief complaint of mandibular pain and paresthesia in the right side of the mental region. He had noticed swelling of the left mandible one month before the initial visit and strong hypesthesia of the right side of the mental region one week before the initial visit. Panoramic radiographs showed slight osteosclerosis of the left side mandible at the initial visit. Blood tests showed only a slight inflammatory reaction. The diagnosis of mandibular osteomyelitis and numb chin syndrome was made, and a contrast-enhanced CT scan was performed to investigate the possibility of neoplastic lesions, but no obvious cause was found. Osteosclerosis was minimal. A tissue biopsy was recommended, but the patient did not consent. Considering the possibility of NCS due to a hematologic disorder, the patient was referred to a hematologist, but no cause could be identified at the initial visit. With time, the markedly severe pain worsened, and the possibility of a neoplastic lesion was again suspected. Blood tests were performed, which revealed abnormally high levels of CA19 and CEA. He consulted a gastroenterologist, who found a tumor in the ileocecal region on contrastenhanced CT, and multiple systemic metastases were found on a PET-CT scan the next day. Systemic chemotherapy was administered for multiple metastatic unresectable colorectal cancer (cT4N1aMc2 stage IVc).

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Numb chin syndrome

Cited by 3 publications

References 91 publications

Oral Problems in Oncology Patients Undergoing Chemotherapy for Solid Tumors: A Prospective Observational Study

Oral Problems in Oncology Patients Undergoing Chemotherapy for Solid Tumors: A Prospective Observational Study

Metastatic gallbladder cancer presenting as numb chin syndrome: A case report and literature review

Numb Chin Syndrome as the Initial Presentation of Mandibular Metastasis of Colorectal Cancer: A Case Report

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