Secondary cluster headache and numb chin syndrome as initial manifestation of high-grade B-lymphoma: a case report

Background Cluster headache is a primary condition characterized by severe headache accompanied by trigeminal autonomic signs. By definition, it is not attributed to underlying etiologies; however, under certain clinical characteristics, secondary etiologies must be ruled out. Case presentation We p...

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Bibliographic Details
Published in:Journal of medical case reports 2021-09, Vol.15 (1), p.1-468, Article 468
Main Authors: Munoz-Cerón, Joe, Díaz-Forero, Felipe, Buitrago, Adriana, Chinchilla, Sandra
Format: Article
Language:English
Subjects:
Biopsy
Cancer
Case Report
Case reports
Classification
Cluster headache
Development and progression
Diagnosis
Etiologies
Etiology
Headaches
Hypotheses
Lymphoma
Magnetic resonance imaging
Medical imaging
Metastasis
Nervous system
Non-Hodgkin's lymphomas
Pain
Secondary headache
Weight loss
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Summary:Background Cluster headache is a primary condition characterized by severe headache accompanied by trigeminal autonomic signs. By definition, it is not attributed to underlying etiologies; however, under certain clinical characteristics, secondary etiologies must be ruled out. Case presentation We present the case of a 48-year-old Hispanic man with a history of episodic right orbital pain, lasting 30 minutes, associated with ipsilateral tearing, who prior to the onset of his symptoms reported loss of appetite, weight loss, and paresthesias in the right chin region. After work-up studies, high-grade lymphoma with infiltration to the right submental nerve was diagnosed, in which numb chin syndrome was the initial presentation. Despite initiation of treatment, the patient died 3 weeks after the diagnosis. Conclusions In the study of cluster headache, underlying etiologies must be considered when there are atypical clinical manifestations. Within these etiologies, metastases to pericranial nerves must be included, which, besides generating localized symptoms, can activate the trigeminal vascular system simulating headaches of primary etiology. Keywords: Cluster headache, Lymphoma, Etiologies, Secondary headache, Cancer
ISSN:1752-1947
1752-1947
DOI:10.1186/s13256-021-03016-9