Metastatic gallbladder cancer presenting as numb chin syndrome: A case report and literature review

Murahashi,Makoto; Ntege,Edward Hosea; Ide,Kentaro; Maruyama,Nobuyuki; Shirakawa,Jumpei; Koyama,Hiroki; Kawano,Toshihiro; Goto,Takahiro; Shimizu,Yusuke; Nishihara,Kazuhide; Nakamura,Hiroyuki

doi:10.3892/br.2024.1749

Metastatic gallbladder cancer presenting as numb chin syndrome: A case report and literature review

Authors:
- Makoto Murahashi
- Edward Hosea Ntege
- Kentaro Ide
- Nobuyuki Maruyama
- Jumpei Shirakawa
- Hiroki Koyama
- Toshihiro Kawano
- Takahiro Goto
- Yusuke Shimizu
- Kazuhide Nishihara
- Hiroyuki Nakamura
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Affiliations: Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of The Ryukyus, Nishihara, Okinawa 903‑0215, Japan, Department of Oral and Maxillofacial Surgery, Okinawa Red Cross Hospital, Naha, Okinawa 902‑8588, Japan, Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903‑0215, Japan
Published online on: February 15, 2024 https://doi.org/10.3892/br.2024.1749
Article Number: 61
Copyright: © Murahashi et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Gallbladder cancer (GBC) is an uncommon malignancy that is highly aggressive in the advanced stages. However, it rarely metastasizes to the mandible. Numb chin syndrome (NCS) is a rare neurological manifestation associated with various underlying causes, including occult primary cancers and distant metastases. It is often considered to be a significant indicator of malignancy, and thorough investigation is essential in the presence of unclear etiology. The current study reported on the case of a 69‑year‑old Japanese woman who presented with numbness and mild pain in the lower lip and chin area for three months. No other systemic symptoms were observed. Immunocytochemical examination revealed the presence of an adenocarcinoma and TNM staging as per the Union for International Cancer Control and the American Joint Committee on Cancer guidelines confirmed stage IVb GBC. Comprehensive full‑body positron emission tomography‑computed tomography examination using ¹⁸F‑fluoro‑2‑deoxy‑D‑glucose revealed additional bone and soft‑tissue metastases. Palliative chemotherapy and radiation treatment were initiated based on the advanced stage of disease at the time of diagnosis. However, the patient succumbed to multiple organ failure six months later. The simultaneous occurrence of GBC, mandibular metastasis and NCS is rare and associated with poor prognosis. Despite the widespread nature of the disease, it can often manifest as non‑specific oral symptoms without any systemic indications. The current study emphasizes the critical importance of timely confirmatory testing for accurate diagnosis and initiation of appropriate management for such complex conditions.

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