頦區麻木症候群與肺癌之遠處轉移－病例報告及文獻回顧

肺癌之初期臨床表現，多以呼吸道症狀爲主，併發頭區麻木之病例尚屬少見。若臨床表現僅以頭、下唇麻木爲主要症狀，而回溯確認診斷爲肺癌者，則更爲罕見。本報告之病患爲38歲女性，主訴爲頦區及唇部持續麻木數月，根據理學檢查及X光攝影，初步診斷爲右下第三大臼齒根尖周炎併發骨髓炎，且不排除有轉移癌之可能，故於局部麻醉下先拔除患齒並進行清創，將檢體送病理檢驗，病理報告確認爲遠處轉移癌症，遂將病患轉介至腫瘤科作進一步評估，檢查發現左上肺葉有一結節，診斷爲第四期非小細胞肺癌合併多處骨轉移。本文亦針對文獻上類似之案例進行回顧分析，希望能提高臨床醫師在遇到頭區麻木症候群時之警覺，注意癌症的可能性。

關鍵字

頦區麻木症候群；非小細胞肺癌

並列摘要

Lung cancer is usually manifested by respiratory symptoms in the early stage. As the disease progresses, numb chin syndrome caused by metastatic lesion may occur occasionally. Numb chin as the initial presentation of lung cancer is rare. Our patient was a 38-year- old lady who complained of numbness at the chin and lower lip lasting for three months. Based on physical examination and radiological study, the tentative diagnosis was apical periodontitis of lower right third molar complicated with osteomyelitis, but the possibility of metastatic cancer could not be ruled out. Under local anesthesia, tooth extraction and debridement was performed and the specimen was sent for histopathological examination. Pathological study confirmed that the bone lesion was a metastatic cancer. The patient was then referred to the Department of Oncology. Further examination revealed a nodule in the left upper lobe of the lung and the patient was finally diagnosed to have stage IV non-small cell lung cancer with multiple bone metastases. In this article, the literature of numb chin syndrome is reviewed. It is hoped that clinicians can be alerted to the possibility of a cancer diagnosis when numb chin patients are encountered.

並列關鍵字

Numb chin syndrome ； Non-small cell lung carcinoma

國際替代計量

頦區麻木症候群與肺癌之遠處轉移－病例報告及文獻回顧

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