■麻木脸颊综合症,一种罕见的下巴麻木综合征的必然结果,是由于眶下神经病.它可能与潜在的恶性肿瘤有关,可以通过直接的恶性神经浸润或通过副肿瘤机制引起神经病变。尽管据报道,脸颊麻木综合征与多种癌症有关,以前没有与乳腺癌相关的报道.我们报告一例左乳癌伴左颊麻木综合征。
■一位65岁的女性出现在神经科诊所,有7个月的左脸颊麻木和偶尔的脸颊压痛病史。检查显示左脸颊的针刺感略有减弱,左乳房肿块隐约可触。脑部磁共振成像扫描显示左上颌神经在圆孔处异常增强,但脑脊液分析正常.乳房X光检查,超声波扫描,和左乳腺核心活检证实诊断为浸润性左乳腺癌(雌激素和孕激素受体阴性,c-erb-B2模棱两可,荧光原位杂交阴性)。在计算机断层扫描和骨闪烁扫描中没有远处转移的证据。患者接受新辅助化疗(阿霉素和环磷酰胺4周期,随后是4个周期的紫杉醇和卡铂),左乳广泛切除术和前哨淋巴结活检,手术切除后2个月进行的重复磁共振成像扫描显示左侧上颌神经增强消退。患者的左颊麻木症状在癌症切除后5个月内得到改善,但没有完全缓解。
■我们的病例代表了首次报道的与乳腺癌相关的左颊麻木综合征,由于没有任何离散肿块或压迫原因的上颌神经病变。为了避免延误诊断恶性肿瘤,内科医生和外科医生应该意识到麻木脸颊综合征可能与潜在的恶性肿瘤相关,乳腺癌应该被计入可能性。
UNASSIGNED: Numb cheek syndrome, a rare corollary of numb chin syndrome, is due to infra-orbital neuropathy. It can occur in association with an underlying malignancy, which can cause neuropathy by direct malignant nerve infiltration or via a paraneoplastic mechanism. Although numb cheek syndrome has been reported in association with a variety of cancers, it has previously not been reported in association with breast cancer. We report a case of left breast cancer presenting with left numb cheek syndrome.
UNASSIGNED: A 65-year-old woman presented to the Neurology clinic with a 7-month history of left cheek numbness and occasional cheek tenderness. Examination revealed slightly diminished pin-prick sensation in the left cheek and a vaguely palpable left breast lump. A magnetic resonance imaging scan of the brain showed abnormal enhancement of the left
maxillary nerve at the foramen rotundum, but cerebrospinal fluid analysis was normal. Mammography, ultrasound scans, and core biopsy of the left breast confirmed the diagnosis of invasive left breast carcinoma (estrogen and progesterone receptor negative, c-erb-B2 equivocal, fluorescence in-situ hybridization negative). There was no evidence of distant metastases on computed tomography and bone scintigraphy scans. The patient underwent neoadjuvant chemotherapy (4 cycles of doxorubicin and cyclophosphamide, followed by 4 cycles of paclitaxel and carboplatin), and left breast wide excision and sentinel lymph node biopsy, and a repeat magnetic resonance imaging scan performed 2 months after surgical resection showed resolution of the left
maxillary nerve enhancement. The patient\'s left numb cheek symptoms improved over a course of 5 months after cancer resection but did not completely resolve.
UNASSIGNED: Our case represents the first reported left numb cheek syndrome in association with breast cancer, due to
maxillary neuropathy without any discrete mass or compressive cause. To avoid delays in diagnosing malignancy, physicians and surgeons should be aware that numb cheek syndrome can occur in association with an underlying malignancy, and that breast cancer should be counted amongst the possibilities.