Secondary trigeminal neuralgia caused by lung adenocarcinoma metastasis on trigeminal nerve roots successfully relieved by opioids: A case report

Minato,Takafumi; Kawai,Kirio; Edamura,Tatsuma; Abe,Hiroaki; Sumitani,Masahiko

doi:10.3892/mco.2024.2724

April-2024 Volume 20 Issue 4

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April-2024 Volume 20 Issue 4

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Case Report

Secondary trigeminal neuralgia caused by lung adenocarcinoma metastasis on trigeminal nerve roots successfully relieved by opioids: A case report

Authors:
- Takafumi Minato
- Kirio Kawai
- Tatsuma Edamura
- Hiroaki Abe
- Masahiko Sumitani
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Affiliations: Department of Pain and Palliative Medicine, The University of Tokyo Hospital, Tokyo 113‑0033, Japan
Article Number: 26
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Published online on: February 8, 2024

https://doi.org/10.3892/mco.2024.2724
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Abstract

Secondary trigeminal neuralgia (TN) is caused by identifiable diseases or lesions of the trigeminal nerve root, Gasserian ganglion and/or pons. TN is a neuropathic pain disorder characterized by electric shock‑like or stabbing pain in the facial region, which can lead to impaired health‑related quality of life. The present case report describes a rare case of secondary TN caused by trigeminal nerve metastases from lung adenocarcinoma, in which opioids provided symptomatic relief. The patient was a 46‑year‑old man with stage IV lung adenocarcinoma. They were admitted to hospital for the introduction of fifth‑line chemotherapy because of previous chemotherapy‑refractory disease progression. Electric shock‑like or stabbing pain in the left facial area and bilateral auditory disturbances coincided with intracranial peri‑brainstem metastases. Facial pain was triggered by mastication, making it difficult for the patient to eat. A fentanyl transdermal patch (25 mcg/h) was initiated following a diagnosis of TN secondary to lung adenocarcinoma metastases on the trigeminal nerves by magnetic resonance imaging. Subsequently, the facial pain improved rapidly. In conclusion, unlike classic and idiopathic TN, which is usually treated with carbamazepine as a first‑line drug, oncologic secondary TN can be treated with opioids.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Secondary trigeminal neuralgia caused by lung adenocarcinoma metastasis on trigeminal nerve roots successfully relieved by opioids: A case report

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