title: Numb chin syndrome secondary to leptomeningeal carcinomatosis from gastric adenocarcinoma.
abstract: Numb chin syndrome (NCS) can be a sign of malignancy. Its association with gastric adenocarcinoma is rare. We report a case of a 27-year-old Hispanic female that presented with complaint of left sided headache associated with numbness of the left side of chin and lower gingiva. Initial brain MRI, whole body gallium scan, high resolution CT of chest and elevated protein in the CSF were suggestive of sarcoidosis. She was treated with IV steroids with transient clinical improvement. Two weeks later, her symptoms worsened and further evaluation revealed the diagnosis of a poorly differentiated metastatic gastric adenocarcinoma with leptomeningeal involvement. This case report aims to emphasize the importance of identifying NCS as a possible indication of an underlying malignant condition. Reported cases of NCS associated with metastatic gastric adenocarcinoma are very rare.
authors.affiliation: 1 Department of Neurology, University of Miami, Miami, FL 33136, USA ; 2 Department of Pathology, University of Miami/Jackson Memorial Hospital, Miami, FL, USA.
authors.forename: Vincent J
authors.initials: VJ
authors.lastname: Riesgo
authors.affiliation: 1 Department of Neurology, University of Miami, Miami, FL 33136, USA ; 2 Department of Pathology, University of Miami/Jackson Memorial Hospital, Miami, FL, USA.
authors.forename: Silvia R
authors.initials: SR
authors.lastname: Delgado
authors.affiliation: 1 Department of Neurology, University of Miami, Miami, FL 33136, USA ; 2 Department of Pathology, University of Miami/Jackson Memorial Hospital, Miami, FL, USA.
authors.forename: Julio
authors.initials: J
authors.lastname: Poveda
authors.affiliation: 1 Department of Neurology, University of Miami, Miami, FL 33136, USA ; 2 Department of Pathology, University of Miami/Jackson Memorial Hospital, Miami, FL, USA.
authors.forename: Kottil
authors.initials: K
authors.lastname: Rammohan
keywords: Numb chin syndrome (NCS); gastric adenocarcinoma; leptomeningeal carcinomatosis (LMC); mental nerve neuropathy; sarcoidosis
references.citation: Crit Rev Oncol Hematol. 2000 Apr;34(1):71-9
references.pmid: 10781749
references.citation: West J Med. 1991 Nov;155(5):528-31
references.pmid: 1815405
references.citation: Radiology. 2000 Jun;215(3):884-5
references.pmid: 10831715
references.citation: AJR Am J Roentgenol. 2008 Mar;190(3 Suppl):S1-6
references.pmid: 18287458
references.citation: Turk J Gastroenterol. 2011;22(2):195-8
references.pmid: 21796558
references.citation: J Clin Oncol. 2008 Jul 1;26(19):3281-4
references.pmid: 18591564
references.citation: Neurology. 2010 May 4;74(18):1449-54
references.pmid: 20439847
references.citation: World J Surg Oncol. 2006 Aug 09;4:52
references.pmid: 16899116
references.citation: J Med Imaging Radiat Oncol. 2014 Dec;58(6):700-5
references.pmid: 24966131
references.citation: Ann Surg Treat Res. 2014 Jan;86(1):16-21
references.pmid: 24761402
references.citation: Cancer. 1998 Feb 15;82(4):733-9
references.pmid: 9477107
references.citation: Oral Surg Oral Med Oral Pathol. 1990 Jan;69(1):48-51
references.pmid: 2153275
references.citation: World J Surg Oncol. 2012 May 03;10:74
references.pmid: 22553956
references.citation: Arch Neurol. 1985 Sep;42(9):909-17
references.pmid: 3896208
references.citation: Neurology. 1979 Oct;29(10):1369-75
references.pmid: 573381