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

TY - JOUR

T1 - Cheek Numbness Caused by Perineural Tumor Invasion of the Infraorbital Nerve

T2 - A Review of 3 Diagnostically Challenging Cases

AU - Okholm, Cecilie

AU - Frendø, Martin

AU - Kiss, Katalin

AU - von Buchwald, Christian

PY - 2018/3/15

Y1 - 2018/3/15

N2 - Objective: Challenging differential diagnosis 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 Reports: 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.

AB - Objective: Challenging differential diagnosis 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 Reports: 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.

KW - Aged

KW - Biopsy

KW - Carcinoma, Squamous Cell/complications

KW - Cheek/innervation

KW - Diagnosis, Differential

KW - Facial Neoplasms/complications

KW - Humans

KW - Hypesthesia/diagnosis

KW - Male

KW - Middle Aged

KW - Neoplasm Invasiveness

KW - Skin/pathology

U2 - 10.12659/AJCR.907034

DO - 10.12659/AJCR.907034

M3 - Journal article

C2 - 29540660

SN - 1941-5923

VL - 19

SP - 296

EP - 300

JO - American Journal of Case Reports

JF - American Journal of Case Reports

ER -