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

Eleni Sarlani, Anthony H. Schwartz, Joel D. Greenspan, Edward G. Grace

Research output: Contribution to journalReview articlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)262-267
Number of pages6
JournalJournal of orofacial pain
Volume17
Issue number3
StatePublished - Oct 3 2003
Externally publishedYes

Keywords

  • Cluster headache
  • Facial pain
  • Lung cancer
  • Referred pain
  • Vagus nerve

ASJC Scopus subject areas

  • Dentistry(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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