The numb chin in breast cancer

Abstract

SUMMARY Numbness of the chin, an uncommon neurological symptom, was observed in 15 patients with cancer. Thirteen had breast cancer. This symptom usually heralded progressive involvement of the cranial nerves or cerebrum and denoted a poor prognosis in patients with a short 'tumourfree interval'. The pathogenesis is commonly related to dural involvement of the Vth cranial nerve at the base of the brain, although metastasis to the mandible might sometimes be implicated. The reason for the peculiar predilection for the mandibular branch of the trigeminal nerve to be affected by breast cancer is not known.

Herald Facial Numbness

“…In one report, renal cell carcinoma presented with Garcin's syndrome [10]. The pathogenesis of the numb chin syndrome is related to the direct infiltration or compression of the mental nerve by the jaw metastasis of tumors, as in our patient and in most postmortem studies [11], Some reports also suggested the involvement of the trigeminal nerve roots by metastatic meningeal tumors [12], Pre vious studies have repeatedly shown that the prognosis is poor in the majority of patients with numb chin as the symptom of a metastatic cancer: partial resolution oc curred in 16/19 patients receiving radiation or chemo therapy, but 16/19 died withing 17 months in one study [8].…”

Rizotomia percutânea por radiofreqüência no tratamento das algias ororrinofaringofaciais resultantes de tumores malignos

“…Metástases ósseas ou meníngeas de carcinomas, linfomas e melanomas 34 , schwanomas malignos, sarcomas trigeminais e infiltração das estruturas trigeminais por tumores malignos da cavidade oral e nasofaringe, podem freqüentemente causar dor no território do tronco nervoso acometido 89 . Os tumores malignos da base do crânio, geralmente carcinomas ou sarcomas da ororrinofaringe, podem erodir a estrutura óssea ou invadir a cavidade craniana pelos orifícios naturais, comprimir e destruir o gânglio de Gasser, as divisões periféricas ou a raiz do nervo trigêmeo, glossofaríngeo e raízes cervicais e originar dor, geralmente constante, acompanhada de anormalidades sensitivo-motoras e, freqüentemente, de lesões associadas de outros nervos cranianos 7,9 .…”

Solitary Metastasis From Occult Follicular Carcinoma of the Thyroid Mimicking Trigeminal Neurinoma. Case Report.

“…6) Metastases from breast carcinoma to the trigeminal nerve have been reported. 7,8,11) In the majority of these cases, the mononeuropathy was not caused by direct metastasis to the affected nerve but was secondary to diffuse metastasis to the leptomeninges, dura mater, or cavernous sinus. Trigeminal mononeuropathy caused by neoplastic lesions is associated mainly with trigeminal schwannoma and tumors arising from the cerebellopontine angle, 12) invasive tumors of the neck and nasopharynx, 6) and meningeal involvement by leukemia 4) or carcinomatosis.…”

“…Previously, 22 patients have been reported in whom the first clinical symptom of intracranial metastasis was trigeminal mononeuropathy. 2,8,14) However, all 22 patients had diffuse tumor metastases in the brain or meningeal infiltration which was detected during postmortem examination. Isolated metastasis to the trigeminal nerve or ganglion by a hematogenous route from a distant, solid tumor is extremely rare.…”

“…13) Cranial nerve involvement is uncommon, and involvement of the trigeminal nerve/ganglion by metastatic tumors is extremely rare, with only 26 documented cases. 2,3,5,[7][8][9][10][11]14) Trigeminal nerve/ganglion involvement is a recognized manifestation of metastasis from primary tumors of the neck and nasopharynx. 6) Metastases from breast carcinoma to the trigeminal nerve have been reported.…”