RT  - Journal of Oral & Facial Pain and Headache
ID  - 10.11607/jofph.17262
T1  - Facial Pain as First Manifestation of Lung Cancer:  A Case of Lung Cancer-Related Cluster Headache and a Review of the Literature
A1  - Eleni Sarlani
A1  - Anthony H. Schwartz
A1  - Joel D. Greenspan
A1  - Edward G. Grace
K1  - cluster headache; facial pain; lung cancer; referred pain; vagus nerve
YR  - 2003
SP  - 262
AB  - <p><i>Facial pain can, on rare occasions, be the presenting symptom of lung cancer. This report describes a patient with non-metastatic lung cancer, which was associated with attacks of debilitating facial pain, presenting as cluster headache. Moreover, 32 reported cases of lung cancer–related facial pain (including the present one) are reviewed, and their clinical features are summarized. The facial pain is almost always unilateral, and is most commonly localized to the ear, the jaws, and the temporal region. The pain is fre-quently described as severe and aching, and may be continuous or intermittent. Aggravation and expansion of the pain, digital club-bing, increased erythrocyte sedimentation rate, and hypertrophic osteopathy, may contribute to the diagnosis. Referred pain, due to invasion or compression of the vagus nerve, as well as paraneo-plastic syndrome secondary to the production of circulating humoral factors by the malignant tumor cells, is implicated in the pathophysiology of facial pain associated with non-metastatic lung cancer. Radiotherapy and tumor resection with vagotomy are very effective in aborting the facial pain. Thus, lung cancer should be included in the differential diagnosis of facial pain that is atypical and/or refractory to treatment. </i></p>