Unilateral Facial Pain as The First Symptom of Lung Cancer: Are There Diagnostic Clues?

Schoenen, Jean; R, Broux; Moonen, Gustave

doi:10.1046/j.1468-2982.1992.1203178.x

Cited by 23 publications

(16 citation statements)

References 6 publications

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“…Rarely, unilateral facial pain can herald the diagnosis of intrathoracic, nonmetastatic lung cancer. In previous reports of such an association, the underlying cancer was most often discovered on routine chest radiograms 1,3‐13 . We report 2 cases of facial pain associated with lung cancer in which an initial chest film failed to detect underlying malignancy.…”

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confidence: 84%

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Facial Pain as the Presenting Symptom of Lung Carcinoma With Normal Chest Radiograph

Abraham¹,

Capobianco

Cheshire

2003

Headache

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Facial pain is a rare presenting symptom of nonmetastatic lung carcinoma. Referred pain from tumor invasion and compression of the vagus nerve was the presumed cause in the 31 cases published to date. We report 2 additional cases having an unusual clinical feature, namely, both had radiographic evidence of malignancy absent on initial chest films. Severe facial pain in both cases was explained by pulmonary carcinoma detected only through further investigations. From these cases follows the notable conclusion that referred facial pain of malignant origin can occasionally precede the appearance of neoplasm on routine chest films. It is therefore important for physicians to be familiar with the clinical features of this syndrome in order to choose appropriate further diagnostic testing in patients who may be at risk.

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confidence: 84%

“…The combined medical literature to date has documented 31 cases from which a common clinical pattern has emerged. All of these patients presented with atypical unilateral facial pain and were ultimately diagnosed with ipsilateral lung carcinoma 1,3‐13 . Key clinical features are summarized in the Table 1.…”

Section: Commentsmentioning

confidence: 99%

Facial Pain as the Presenting Symptom of Lung Carcinoma With Normal Chest Radiograph

Abraham¹,

Capobianco

Cheshire

2003

Headache

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“…Orofacial pain referred from non-metastatic cancer is very rare but it has been reported that lung cancer and mediastinal malignant disease secondary to lung cancer can refer orofacial pain in the ipsilateral side (37,38). This referred pain could be provoked by compression of the vagus nerve by the lung (or any other organ or structure along the nerve), causing a convergence of somatic and visceral afferent inputs to the trigeminal nucleus caudalis, causing pain symptomatology in these regions (39).…”

Section: Orofacial Pain As a Symptom Of Cancermentioning

confidence: 99%

“…This referred pain could be provoked by compression of the vagus nerve by the lung (or any other organ or structure along the nerve), causing a convergence of somatic and visceral afferent inputs to the trigeminal nucleus caudalis, causing pain symptomatology in these regions (39). The pain has been described as intractable, unexplained, debilitating, severe, aching and paroxysmal, and with a poor response to therapy (37,38,40,41). Furthermore, neuralgic symptoms such as trigeminal neuralgia have been reported as the only symptom of pancreatic cancer (42).…”

Section: Orofacial Pain As a Symptom Of Cancermentioning

confidence: 99%

Cancer and orofacial pain

Salvemini

2016

Med Oral

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BackgroundCancer pain is a devastating condition. Pain in the orofacial region, may be present as the single symptom of cancer or as a symptom of cancer in its later stages. This manuscript revises in a comprehensive manner the content of the conference entitled “Orofacial Pain and Cancer” (Dolor Orofacial y Cancer) given at the VI Simposio International “Advances in Oral Cancer” on the 22 July, 2016 in Donostia.Material and MethodsWe have reviewed (pubmed-medline) from the most relevant literature including reviews, systematic reviews and clinical cases, the significant and evidence-based mechanisms and mediators of cancer-associated facial pain, the diverse types of cancers that can be present in the craniofacial region locally or from distant sites that can refer to the orofacial region, cancer therapy that may induce pain in the orofacial region as well as discussed some of the new advancements in cancer pain therapy.ResultsThere is still a lack of understanding of cancer pain pathophysiology since depends of the intrinsic heterogeneity, type and anatomic location that the cancer may present, making more challenging the creation of better therapeutic options. Orofacial pain can arise from regional or distant tumor effects or as a consequence of cancer therapy.ConclusionsThe clinician needs to be aware that the pain may present the characteristics of any other orofacial pain disorder so a careful differential diagnosis needs to be given. Cancer pain diagnosis is made by exclusion and only can be reached after a thorough medical history, and all the common etiologies have been carefully investigated and ruled out. The current management tools are not optimal but there is hope for new, safer and effective therapies coming in the next years. Key words:Pain, orofacial, facial, cancer.

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“…(Jones & Lawson, 1987;Bindoff & Heseltine,1988;Nestor, 1991;Broux 1991;Bongers et al, 1992;Schoenen et al, 1992;Nestor & Ngo, 1994;Capobianco, 1995;Shakespeare & Stevens, 1996;Goldberg, 1997;Abraham et al, 2003;Sarlani et al, 2003;Eross et al, 2003;Demez et al, 2004;Palmieri, 2006). However, the central connections responsible for referred pain in such clinical cases have not been thoroughly reviewed.…”

Section: Introductionmentioning

confidence: 99%

Thoracic Vagal Ganglion and Referred Craniofacial Pain: a Case Report and Review

et al. 2007

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SUMMARY:The presence of a ganglion-like tumefaction is reported in the mediastinal course of the right vagus nerve at T1 level in a cadaver in the Universidad Industrial de Santander's morphology laboratory. The vagal ganglion was located next to hyperplasic lymphoid nodes in para-tracheal and tracheal-bronchial levels, agglomerating in a large lymphoid mass in the carina and the pulmonary hilum. Anatomical-pathological study revealed a marked, diffusely distributed, predominantly histo-lymphocyte mixed inflammation, separating the epineurium, producing lysis of the vagus nerve fibers. This finding showed the degeneration of this cranial par by mediastinal pathology. This provided a possible explanation for the physiopathology of pain referring to the head and neck in inflammatory or neoplastic pathology involving compression and degeneration by inflammatory infiltration of the vagus nerve. Pons-medullar trigeminal afferent tracts and connectivity, supra-spinal pathways for processing somatic-visceral pain, possible somatic-vegetative responses and the integration of the trigeminal system in the physiology of pain concerning the vagus nerve are all discussed.

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Unilateral Facial Pain as The First Symptom of Lung Cancer: Are There Diagnostic Clues?

Cited by 23 publications

References 6 publications

Facial Pain as the Presenting Symptom of Lung Carcinoma With Normal Chest Radiograph

Facial Pain as the Presenting Symptom of Lung Carcinoma With Normal Chest Radiograph

Cancer and orofacial pain

Thoracic Vagal Ganglion and Referred Craniofacial Pain: a Case Report and Review

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