Silent presentation of B-Cell Lymphoma in the mandible

Abstract

The manifestation of extranodal non-Hodgkin lymphoma in the mandible is uncommon. Classically, presence of swelling, teeth mobility, pain and paraesthesia intraorally are pathognomonic signs of oral malignancies. However, there are very few reported cases of oral manifestation of lymphoma with the only complaint being numb chin syndrome. Here, we report a 50-year-old patient who presented with numb chin syndrome and no clinical evidence of malignancy intraorally. Further investigations and biopsy confirmed the presence of diffuse B-cell lymphoma. This case highlights the diagnostic challenges of silent presentation of B-cell lymphoma in the mandible. Furthermore, numb chin syndrome can be an early presentation of oral malignancy and hence, clinicians should have a low threshold for urgent referral to secondary care and for thorough investigation to avoid misdiagnosis and treatment delays.

Keywords

• Lymphoma
• Non-hodgkins lymphoma
• B-Cell lymphoma
• Numb chin syndrome
• NCS
• Mandible