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Facial pain as first manifestation of lung cancer: a case of lung cancer-related cluster headache and a review of the literature.

Abstract
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.
AuthorsEleni Sarlani, Anthony H Schwartz, Joel D Greenspan, Edward G Grace
JournalJournal of orofacial pain (J Orofac Pain) Vol. 17 Issue 3 Pg. 262-7 ( 2003) ISSN: 1064-6655 [Print] United States
PMID14558496 (Publication Type: Case Reports, Journal Article, Review)
Chemical References
  • Cytokines
Topics
  • Adult
  • Carcinoma, Non-Small-Cell Lung (complications, diagnosis)
  • Cluster Headache (etiology, surgery)
  • Cytokines (blood)
  • Diagnosis, Differential
  • Facial Pain (etiology, surgery)
  • Fatal Outcome
  • Humans
  • Lung Neoplasms (complications, diagnosis)
  • Male
  • Nerve Compression Syndromes (complications, etiology, surgery)
  • Paraneoplastic Syndromes (diagnosis)
  • Vagotomy
  • Vagus Nerve (physiopathology)

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