Sugawara C, Takahashi A. Orofacial symptoms suggestive of malignant lesions and the role of imaging: literature review and case presentation. Oral Radiol 2023; 39: 599-613.

The importance of radiographic examination is emphasised.

Using well-illustrated case presentations, the authors describe symptoms with which patients with undiagnosed malignant disease may present at a dental practice. The symptoms described here are:

  • Numb chin syndrome (NCS) - NCS may be associated with malignant lesions which include malignant and metastatic tumours of the mandible, intracranial tumours arising in the region of the trigeminal nerve, and malignant tumours of hematopoietic origin

  • Trismus and TMJ disorders - although there are multiple possible causes of TMJ disorders, two cases are reported where malignant tumours had invaded the masticatory muscle spaces causing trismus

  • Painless swelling in the head and neck region, including macroglossia - any painless swelling should be treated with suspicion and further investigations carried out as appropriate. Cases of myeloma, oesophageal cancer and non-Hodgkin's lymphoma with such presentations are shown.

The authors highlight the importance of careful clinical examination, of correctly positioned panoramic radiographs, and of subsequent thorough interpretation of the images.