Numb Chin Syndrome as the Initial Manifestation of Breast Carcinoma

Abstract

Numb chin syndrome may be the manifestation of a local dental pathology or secondary to a systemic disease. A systematic physical examination with diagnostic workup is of utmost importance in patients presenting with numb chin syndrome. We report the case of a 58-year-old woman who presented with numb chin syndrome. An orthopantogram and computed tomography of the head revealed osteolytic lesion in the left molar region. Histopathological and immunohistochemical examination confirmed the lesion to be metastatic breast carcinoma. Breast ultrasound scan demonstrated a 1.5 × 1.5-cm lesion in the left breast and fine needle aspiration cytology from the lesion confirmed the diagnosis of breast carcinoma. Bone scan showed multiple bone metastases. She was diagnosed to have numb chin syndrome secondary to bone metastases from breast carcinoma. In view of her disseminated disease status, she was started on palliative hormone therapy (Letrozole) with zoledronic acid. We present this case to highlight the importance of careful evaluation of patients presenting with numb chin syndrome because this may be the only manifestation of a systemic malignancy.