Facial pain can, on rare occasions, be the presenting symptom of
lung cancer. This report describes a patient with non-metastatic
lung cancer, which was associated with attacks of debilitating
facial pain, presenting as
cluster headache. Moreover, 32 reported cases of
lung cancer-related
facial pain (including the present one) are reviewed, and their clinical features are summarized. The
facial pain is almost always unilateral, and is most commonly localized to the ear, the jaws, and the temporal region. The
pain is frequently described as severe and aching, and may be continuous or intermittent. Aggravation and expansion of the
pain, digital clubbing, increased erythrocyte sedimentation rate, and hypertrophic osteopathy, may contribute to the diagnosis.
Referred pain, due to invasion or compression of the vagus nerve, as well as
paraneoplastic syndrome secondary to the production of circulating humoral factors by the malignant
tumor cells, is implicated in the pathophysiology of
facial pain associated with non-metastatic
lung cancer.
Radiotherapy and
tumor resection with
vagotomy are very effective in aborting the
facial pain. Thus,
lung cancer should be included in the differential diagnosis of
facial pain that is atypical and/or refractory to treatment.