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Referred facial pain associated with lung cancer: Case reports and phenotype-based management
Madha Mansoor1, Shehryar N Khawaja1,2,3
1Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.
Background:
Referred facial pain is a rare but important presentation of systemic disease. This paper describes orofacial pain associated with lung cancer, discusses key diagnostic considerations, and illustrates phenotype-based management. i.
Clinical Presentation:
Two patients with known pulmonary malignancy developed unexplained orofacial pain. Case 1 involved a 37-year-old male with dull, intermittent pain in the left ear and face. Case 2 involved a 63-year-old female with episodic, burning pain radiating from the right pharynx, right face and ear. Both were misdiagnosed, one as persistent idiopathic facial pain (atypical facial pain), the other as glossopharyngeal neuralgia. Clinical examination and imaging revealed no local pathology. Their pain was attributed to referred pain from lung cancer. Both responded to phenotype-guided management, including tricyclic antidepressants, gabapentinoids, and carbamazepine.
Conclusion:
These cases highlight the diagnostic challenges of facial pain attributed to lung cancer (FPLC), its frequent misdiagnosis, the need for dedicated diagnostic criteria and phenotype-based management.
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