Squamous cell carcinoma presenting with trigeminal anesthesia: An uncommon presentation of head & neck cancer with unknown primary

• Published in: American journal of otolaryngology 2017-03, Vol.38 (2), p.153-156
• Main Authors: Shah, Ameer T, Dagher, Walid I, O ' Leary, Miriam, Wein, Richard O
• Format: Article
• Language: English
• Subjects: Accidents; Adenocarcinoma; Adenoid; Aged; Alcohol; Alcoholic beverages; Alcohols; Anesthesia; Atrophy; Auricle; Beverages; Biopsy; Buccal mucosa; Cancer; Cancer therapies; Carcinoma, Squamous Cell - diagnostic imaging; Carcinoma, Squamous Cell - secondary; Carcinoma, Squamous Cell - surgery; Chemotherapy; Chronic obstructive pulmonary disease; Computed tomography; Consultation; Contrast Media; Demyelination; Diagnosis; Dysphagia; Endoscopy; Etiology; Facial anesthesia; Family medical history; Female; Glucose; Head; Head & neck cancer; Head and Neck Neoplasms - diagnostic imaging; Head and Neck Neoplasms - secondary; Head and Neck Neoplasms - surgery; Humans; Hypertension; Hypesthesia - pathology; Infiltration; Lesions; Lung diseases; Magnetic Resonance Imaging; Male; Malignancy; Metastases; Metastasis; Middle Aged; Mucosa; Muscles; Neoplasm Invasiveness - diagnostic imaging; Neoplasm Invasiveness - pathology; Neoplasms, Unknown Primary; Oral cavity; Otolaryngology; Pain; Pathology; Patients; Perineural spread; Pharmacology; Pituitary gland; Positron emission tomography; Radiation; Radiation therapy; Sinuses; Skin; Skull; Smoking; Squamous cell carcinoma; Surgery; Trigeminal nerve; Trigeminal Nerve - pathology; Tumors; Ultrasound; Unknown primary; Ventricle
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1016/j.amjoto.2016.11.013

A bstract Background The differential diagnosis of facial anesthesia is vast. This may be secondary to trauma, neoplasm, both intracranial and extracranial, infection, and neurologic disease. When evaluating a patient with isolated facial anesthesia, the head and neck surgeon often thinks of adenoid cystic carcinoma, which has a propensity for perineural invasion and spread. When one thinks of head and neck squamous cell carcinoma with or without unknown primary, the typical presentation involves dysphagia, odynophagia, weight loss, hoarseness, or more commonly, a neck mass. Squamous cell carcinoma presenting as facial anesthesia and perineural spread, with no primary site is quite rare. Methods Case presentations and review of the literature . Conclusions Trigeminal anesthesia is an uncommon presentation of head and neck squamous cell carcinoma with unknown primary. We present two interesting cases of invasive squamous cell carcinoma of the trigeminal nerve, with no primary site identified. We will also review the literature of head and neck malignancies with perineural spread and the management techniques for the two different cases presented.