Late recurrence of Burkitt’s lymphoma in the jaw: numb chin syndrome as the only symptom

The Numb Chin Syndrome (NCS) is defined as facial and oral numbness restricted to the mental nerve’s distribution involving the lower lip, skin of the chin, or gingiva of the lower anterior teeth. Hypoesthesia can occur unilaterally or bilaterally. Although this syndrome is rare, its importance is r...

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Main Authors: Bernar Monteiro Benites, Wanessa Miranda-Silva, André Caroli Rocha, Ula Lindoso Passos, Felipe Paiva Fonseca, Celso Arrais Rodrigues da Silva, Eduardo Rodrigues Fregnani
Format: Article
Language:English
Published: University of São Paulo 2021-01-01
Series:Autopsy and Case Reports
Subjects:
Online Access:https://www.revistas.usp.br/autopsy/article/view/180619
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author Bernar Monteiro Benites
Wanessa Miranda-Silva
André Caroli Rocha
Ula Lindoso Passos
Felipe Paiva Fonseca
Celso Arrais Rodrigues da Silva
Eduardo Rodrigues Fregnani
author_facet Bernar Monteiro Benites
Wanessa Miranda-Silva
André Caroli Rocha
Ula Lindoso Passos
Felipe Paiva Fonseca
Celso Arrais Rodrigues da Silva
Eduardo Rodrigues Fregnani
author_sort Bernar Monteiro Benites
collection DOAJ
description The Numb Chin Syndrome (NCS) is defined as facial and oral numbness restricted to the mental nerve’s distribution involving the lower lip, skin of the chin, or gingiva of the lower anterior teeth. Hypoesthesia can occur unilaterally or bilaterally. Although this syndrome is rare, its importance is related to the fact that it represents the clinical manifestations of malignant diseases. Breast cancer and non-Hodgkin lymphoma are the most common cause of NCS. The patient, a 58-year-old woman, treated for a Burkitt Lymphoma (BL) nine years ago, described a two-week history of change in sensitivity and pain in the chin region, without relief with the use of analgesics. She had no headache, speech disturbance, dysphagia, visual disturbance, or other neurological symptoms. No surgical intervention has been performed recently. The intraoral examination revealed a healthy oral mucosa and a small area adjacent to the right mental nerve region that was uncomfortable to palpation. No changes were found in the bone trabeculae at cone-beam computed tomography. The contrasted magnetic resonance features made it possible to identify a change in the mandibular body extending to the entire right side, coinciding with the patient’s complaint, indicating a probable mandibular medullary invasion. The patient was submitted to a biopsy to rule out a possible recurrence of BL. The microscopic findings were consistent with the diagnosis of BL. The present report described a very unusual presentation of late recurrent BL nine years after the first treatment, which manifested as an NCS.
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spelling doaj.art-8f3ce3970c6f4223acdb14043cf069972022-12-21T23:14:30ZengUniversity of São PauloAutopsy and Case Reports2236-19602021-01-0111Late recurrence of Burkitt’s lymphoma in the jaw: numb chin syndrome as the only symptomBernar Monteiro Benites0Wanessa Miranda-Silva1André Caroli Rocha2Ula Lindoso Passos3Felipe Paiva Fonseca4Celso Arrais Rodrigues da Silva5Eduardo Rodrigues Fregnani6Hospital Sírio-Libanês, Serviço de Medicina BucalHospital Sírio-Libanês, Serviço de Medicina BucalUniversidade de São Paulo, Faculdade de Medicina, Hospital das ClínicasHospital Sírio-Libanês, Serviço de Radiologia Universidade de Minas Gerais, Faculdade de Odontologia, Departamento de Patologia OralHospital Sírio-Libanês, Unidade de Transplante de Medula ÓsseaHospital Sírio-Libanês, Serviço de Medicina BucalThe Numb Chin Syndrome (NCS) is defined as facial and oral numbness restricted to the mental nerve’s distribution involving the lower lip, skin of the chin, or gingiva of the lower anterior teeth. Hypoesthesia can occur unilaterally or bilaterally. Although this syndrome is rare, its importance is related to the fact that it represents the clinical manifestations of malignant diseases. Breast cancer and non-Hodgkin lymphoma are the most common cause of NCS. The patient, a 58-year-old woman, treated for a Burkitt Lymphoma (BL) nine years ago, described a two-week history of change in sensitivity and pain in the chin region, without relief with the use of analgesics. She had no headache, speech disturbance, dysphagia, visual disturbance, or other neurological symptoms. No surgical intervention has been performed recently. The intraoral examination revealed a healthy oral mucosa and a small area adjacent to the right mental nerve region that was uncomfortable to palpation. No changes were found in the bone trabeculae at cone-beam computed tomography. The contrasted magnetic resonance features made it possible to identify a change in the mandibular body extending to the entire right side, coinciding with the patient’s complaint, indicating a probable mandibular medullary invasion. The patient was submitted to a biopsy to rule out a possible recurrence of BL. The microscopic findings were consistent with the diagnosis of BL. The present report described a very unusual presentation of late recurrent BL nine years after the first treatment, which manifested as an NCS.https://www.revistas.usp.br/autopsy/article/view/180619Burkitt LymphomaRecurrenceHypesthesiaB-lymphocytes
spellingShingle Bernar Monteiro Benites
Wanessa Miranda-Silva
André Caroli Rocha
Ula Lindoso Passos
Felipe Paiva Fonseca
Celso Arrais Rodrigues da Silva
Eduardo Rodrigues Fregnani
Late recurrence of Burkitt’s lymphoma in the jaw: numb chin syndrome as the only symptom
Autopsy and Case Reports
Burkitt Lymphoma
Recurrence
Hypesthesia
B-lymphocytes
title Late recurrence of Burkitt’s lymphoma in the jaw: numb chin syndrome as the only symptom
title_full Late recurrence of Burkitt’s lymphoma in the jaw: numb chin syndrome as the only symptom
title_fullStr Late recurrence of Burkitt’s lymphoma in the jaw: numb chin syndrome as the only symptom
title_full_unstemmed Late recurrence of Burkitt’s lymphoma in the jaw: numb chin syndrome as the only symptom
title_short Late recurrence of Burkitt’s lymphoma in the jaw: numb chin syndrome as the only symptom
title_sort late recurrence of burkitt s lymphoma in the jaw numb chin syndrome as the only symptom
topic Burkitt Lymphoma
Recurrence
Hypesthesia
B-lymphocytes
url https://www.revistas.usp.br/autopsy/article/view/180619
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