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15 March 2018 : Case report  Denmark

Cheek Numbness Caused by Perineural Tumor Invasion of the Infraorbital Nerve: A Review of 3 Diagnostically Challenging Cases

Challenging differential diagnosis

Cecilie Okholm1ABCDEF*, Martin Frendø1ABCDEF, Katalin Kiss2ABCDEF, Christian von Buchwald1ABCDEF

DOI: 10.12659/AJCR.907034

Am J Case Rep 2018; 19:296-300

Abstract

BACKGROUND: Facial pain and numbness are common symptoms with a variety of causes; rarely, it is an initial sign of perineural infiltration of malignant tumors.

CASE REPORT: Here, we report 3 challenging cases, all presenting with pain and numbness of the cheek as the primary symptoms. Upon referral, there were neither signs of severe illness nor information about previous malignant diseases, while the diagnostic work-ups revealed additional involvement of the facial nerve in 2 of the cases. Surgical removal of the perineural tissue around the infraorbital nerve revealed perineural invasion by a squamous carcinoma. A more thorough review of their medical histories revealed that all 3 of the patients had had previous facial skin cancer.

CONCLUSIONS: Numbness or pain in the cheek may represent perineural invasion of a facial cutaneous carcinoma. This review of 3 cases addresses the necessity of identifying previous incidences of skin cancer in the medical history.

Keywords: Carcinoma, Squamous Cell, facial pain, Neuralgia, Skin Neoplasms

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923